颈椎管狭窄外伤后颈髓损伤的手术治疗

目的分析无骨折、脱位的颈髓损伤的主要原因，探讨其治疗对策。方法回顾性分析我院1998年1月至2008年月12月共96例颈椎管狭窄外伤后颈髓损伤行后路单开门椎管成形术治疗。结果术后随访6个月至2年，A级中5例进步至B级．6例进步至c级，5例进步至D级；B级中7例进步至c级，10例进步至D级，11进步至E级；C级中14例进步至D级，20例进步至E级；D级均进步至E级。结论颈椎管狭窄具有一定隐蔽性；是颈髓损伤的潜在高危因素之一；是无骨折、脱位的颈髓损伤的主要原因。采用后路单开门椎管成形加关节突间植骨术治疗颈椎管狭窄外伤后颈髓损伤，是有效的治疗方法，它的优点在于能广泛减压，充分扩大椎管：对颈椎的稳定性破坏不大，而且颈椎后路手术后再行前路减压也是必要和可行的。同时本术式操作简单、方便、安全．便于开展。

Surgical Strategy of Cervical Cord Injury for Cervical Cannal Stenosis Combined Trauma

Objective To investigate the primary factor for cervical cord injury without fracture and dislocation, study the treatment for this injury. Methods Retrospectively analyzing 96 patients with neck injury combined with cervical canal stenosis who had undergone cervical posterior unilateral laminoplasty in our hospital between January 1998 and December 2008. Results Following up at least 6 months （at most 2 years） after surgery, 5 in ASIA A grade were to be B, 6 to C, 5 to D; 7 in patients ASIA B grade were to be C, 10 to D, 11 to E; 14 in C grade were to be D, 20 to E; D gerade all to be E. Conelutions For it is hidden, cervical stenosis is a presence high risk for cervical cord injury, which is also a main reason for cervical cord injury without frescture or dislocation. Posterior unilateral laminoplasty combined with interbody fusion is an effective method to treat cervical cord injury for neck trauma combined with cervical stenosis. This surgry can decompress thoroughly, enlarge canal sufficiently, invade minimally the stability of cervical, and anterior decrompression after cervical posterior approach is necessary and feasible. This approach could conduct simply, conveniently, safely and easily.