对急性创伤性无骨折脱位型颈髓损伤的病因探讨

作者报道近年来收治的急性创伤性无骨折脱位型颈髓损伤患者２７例。常规Ｘ线及ＣＴ扫描均不能确切了解脊髓损伤的真正原因和致伤机理。１６例经ＭＲＩ检查表明两种机制造成了脊髓损伤：（１）脊髓的一过性挫伤。由伤时椎间瞬间的小位移造成，原先存在的颈椎退变因素也参与了损伤。（２）脊髓的持续性压迫。主要由急性外伤性椎间盘突出造成。作者强调对本病的诊断应提高警惕，对Ｘ线等检查无骨折脱位而临床表现有脊髓损伤者应首选ＭＲＩ检查。

The Causes of Acute Traumatic Cervical Spinal Cord Injury without Fracture and Dislocation

Twenty_seven patients with acute traumatic cervical spinal cord injury (SCI) without fracture and dislocation were studied. By analyzing the clinical data, the authors found that the conventional radiography and CT scan could not reveal the true causes of the SCI. MRI examination of 16 patients indicated that this kind of injury mainly caused by the following two mechanisms: (1) Transicent injury to the spinal cord after slight displacement between the approximate vertebrae superimposed upon the original degenerative pathogen on the cervical canal, as often seen in the aged group. (2) Compression on the spinal cord by the prolapsed intervertebral disc. The authors emphasize that it is necessary to be alert to this kind of injury and MRI is the first choice to make the diagnosis.