下颈椎损伤分类评分系统的临床应用

目的评估SLIC评分系统对下颈椎损伤治疗的指导作用。方法对76例下颈椎损伤患者行颈椎X线、CT、MRI检查和系统的神经学体检,按照SLIC系统的原则对骨折形态、间盘韧带复合体(DLC)状态和神经功能状态3个方面进行评估。根据影像学检查将骨折形态分为:无异常、压缩型、爆裂型、牵张型和旋转/平移型;将DLC损伤分为:无损伤型、不确定型、断裂型;根据神经学体检将神经损伤状态分为:无损伤、神经根损伤、完全性/不完全性脊髓损伤和持续脊髓压迫损伤。根据SLIC评分系统选择治疗方法,评估患者的神经功能恢复情况和并发症发生情况。结果 76例均获得随访,时间9~22(12.6±1.2)个月。15例评分≤4分的患者选择非手术治疗,其中有4例评分=4分者转为手术治疗;8例评分=4分及53例评分≥5分的患者均选择手术治疗。治疗后除6例脊髓完全性损伤者神经功能无好转外,其余患者神经功能均有不同程度的改善。结论 SLIC评分系统具有较高的可靠性,且使用简单,易于掌握,此方法对于颈椎损伤的评估较全面和准确,可以作为患者临床治疗选择的依据。

Clinical application of the sub-axial cervical spine injury classification system

Objective To evaluate the effect of sub-axial cervical spine injury classification ( SLIC ) system on the treatment of sub-axial cervical spine. Methods 76 patients with sub-axial cervical spine were selected. All patients underwent cervical spine X-ray, CT, MRI and neurological examination. All patients were evaluated according to the principle of SLIC system, including fracture morphology, disco-ligamentous complex ( DLC) damage, and neurologi-cal status. According to the imaging examination, the fracture morphology was divided into:no damage, compression type, burst type, distraction type and rotation/translation type;DLC damage was divided into:intact, indeterminate, and disrupted. According to the neurological status, the state of nerve injury was divided into:intact, nerve root inju-ry, complete/incomplete spinal cord injury and continuous spinal cord compression injury. According to the SLIC scoring system, the treatment method was selected, the recovery of neurological function and complications was evalu-ated. Results 76 patients were followed up for 9~22 (12. 6 ± 1. 2) months. 15 cases with scores≤4 points were chosen conservative treatment. 4 cases with scores equal to 4 points chosen conservative treatment finally turned to surgical treatment. 8 cases of patients with scores equal to 4 points and 53 cases with scores≥5 points were selected for surgical treatment. The neurological function of the patients were improved after treatment except 6 patients with complete spinal cord injury. Conclusions SLIC scoring system has high reliability, and is simple and easy to mas-ter. This method can be used in the evaluation of cervical spine injury, which can be used as a basis for the choice of clinical treatment.