小儿颈椎及颈脊髓损伤

目的 总结小儿颈椎及颈脊髓损伤的诊断治疗经验。方法 回顾分析４７例小儿颈椎及颈脊髓损伤。男３１例，女１６例，年龄６－１４岁，平均１１．６岁。新鲜损伤１９例，陈旧性损伤２８例。其中上颈椎损伤３３例，下颈椎损伤１０例，多节段间隔性颈椎损伤１例。无Ｘ线异常的脊椎损伤３例，非手术治疗２７例，手术治疗１９例，未治１例。结果 早期死亡１例。４５例获１－１２年随访，恢复正常或接近正常者３４例，明显改善者６例，５

Pediatric Cervical Spine and Spinal Cord Injuries

Objective This study is designed to provide the experience in diagnosis and treatment of cervical spine and spinal cord injuries in children. Methods Forty seven children with cervical spine and spinal cord injuries were retrospectively reviewed. There were 31 males and 16 females, with their age ranging 6 to 14 years (mean, 11.6 years). Nineteen children had fresh injuries, whereas the remaining 28 sustained old injuries. Of these patients, thirty one patients were identified with injuries of upper cervical spine, 10 were with injuries of lower cervical spine, 1 was with multiple noncontiguous injuries of cervical spine, and 3 were with spinal cord injuries without radiographic abnormalities. All these patients underwent nonoperative (27 cases) or operative (19 cases) treatment except one who refuse treatment. Results A follow up for 1 to 12 years showed that 34 patients had complete or significant improvement, six had moderate improvement and 5 remained unchanged. Conclusions Imaging assessment is of great importance to diagnosis and treatment of cervical spine and spinal cord injuries in children. Most injuries do not require surgical intervention, but decompression and/or fusion should be indicated in those patients with unstable injuries that cannot be reduced and stablilized by conservative therapy or progressive neurological deficit.