手术治疗无骨折脱位型颈脊髓损伤

目的探讨不同类型无骨折脱位型颈脊髓损伤手术方式选择,观察治疗效果。方法本组24例,短节段（≤2个节段）椎间盘突出6例行前路手术。多节段（≥3个节段）颈椎管狭窄18例行后路手术,其中1例合并C5～6髓核游离于椎管,二期再行前路手术。结果 JOA评分术前平均5.70分,术后6周评分平均8.47分,术后12周10.26分,术后24周为12.02分。所有病例均获骨性融合。结论根据不同的病理类型,选择适当的手术方式,彻底减压,可靠融合及内固定,可取得较满意疗效。

Surgery for cervical spinal cord injury without fracture or dislocation of the spinal column

Objective To investigate the appropriate surgical approach in the management of the different types of cervical spinal cord injury without fracture or dislocation. Methods The clinical data of 24 patients with cervical spinal cord injury without fracture or dislocation who received surgical treatment were retrospectively analyzed. Six patients with short-segmental （≤2 segments） cervical disc hermiatin were subjected to anterior decompression. Eighteen patients with multi-segmental （≥3 segments） spinal canal stenosis to posterior decompression,and one of them with C5-6 disc separated from the spinal canal was treated with anterior decompression at second-stage surgery.Results The average preoperative JOA score was 5.70 points,8.47,10.26 and 12.02 points on average 6 weeks,12 weeks,and 24 weeks respectively after surgery. All the cases obtained bone fusion.Conclusion According to different types of pathology,selecting the appropriate surgical approach,complete decompression,reliable fusion and internal fixation can gain satisfactory curative effects.