颈椎过伸致颈髓损伤的机制探讨

目的:探讨颈椎过伸致颈椎损伤的机制,为临床治疗提供依据。方法:回顾性分析214例手术和保守治疗的颈椎过伸性损伤患者,对治疗结果及神经功能恢复情况进行比较。结果:214例颈椎过伸颈髓损伤人,保守治疗54例,手术治疗160例。脊髓神经功能恢复按Frankle分级;保守治疗组:治疗前A级6例,B级18例,C级15例,D级5例,E级10例。治疗后A级2例,B级3例,C级14例,D级13例,E级22例。手术治疗组:治疗前A级20例,B级70例,C级26例,D21例,E级23例。治疗后A级1例,B级11例,C级19例,D级53例,E级76例。手术组神经功能恢复情况优于保守治疗组。结论:过伸性颈椎损伤后颈椎的原发病存在是引发颈髓损伤重要病理基础,脊髓椎管存在着类似于“骨筋膜室综合征”的病理改变,早期手术彻底减压有利于脊髓神经功能恢复。

Mechanism on the extention injury of cervical spinal cord

AIM:To investigate the extention injury of cervical spinal cord and to provide the basis for clinical therapeutics. METHODS:214 cases patients (surgical treatment group and conservative treatment group )were analyzed retrospectively in the extention injury of cervical spinal cord. The therapeutic outcomes and the nerve functional restoration were compared between the two groups. RESULTS:Among 214 cases,there were 160 cases for surgical treatment and 54 cases for conservative treatment. The restoration of spinal cord nerve functional had been graded by the Frankle's method.In the group of conservative treatment : Frankle A ,B,C,D and E were 6,18,15,5 and 10 cases respectively before treatment and Frankle A ,B,C,D and E were 2,3,14,13 and 22 cases after treatment. In the group of the operation therapeutics: Frankle A ,B,C,D and E were 20,70,26,21 and 23 cases before treatment and Frankle A ,B,C,D and E were 1,11,19,53 and 76 cases after treatment. The nerve functional restoration of the surgical treatment group was superior to the conservative treatment group.