颈髓完全性损伤治疗方法的选择

报告了４２例颈髓完全性损伤非手术治疗的结果。平均年龄２９．７岁。骨折分类：屈曲型２５例，压缩型１０例，过伸型７例。损伤椎节为Ｃ_４～Ｃ_７，平均观察时间为７．８个月。按Ｆｒａｎｋｅｌ分级，仅有４例（９．５％）进步到Ｂ级；按胥少汀对完全性颈髓损伤的修正疗效标准，神经功能改善率为５２．３％。损伤当时截瘫平面高于或等于骨折节段者有较好的恢复率，而低于者无恢复。分析对比了文献报道的早期手术治疗结果，认为：颈髓完全性损伤早期手术与非手术治疗结果无明显差异。强调对完全性损伤早期判断的重要性，建议制定统一的疗效评定标准，并就相关问题进行了讨论。

Neurological recovery after conservative treatment for complete injuries of cervical cord

A series of 42 patients with closed traumatic complete injuries of the cervical cord were reported.The average age at the time of injury was 29. 7 years. The mechanism of injury was classified according to Kiwerski. The segments of injuried-vertebra from C_4 to C_7. The average time of followed up was 7. 8 months. Four cases (9. 5%) were improved to grade B according to Frankel. However,using the modified criteria for complete injuries of the cervical cord according to XIU Shao-tin,the recovery rate was 52. 3%. The initial neurological level higher than the level of skeletal was a good prognostic sign for recovery. The importance of early correct diagnosis for complete injuries of cervical cord was emphasized.It was recommended that universal criteria of neurological recovery should be made.Author's address (Wuhan General Hospital,Guangzhou Unit of PLA,Wuhan,Hubei, 430070)