过伸性颈椎颈髓损伤的诊断和治疗

报道４３例过伸性颈椎颈髓伤。所有病例均进行了ＭＲＩ检查，结果示颈椎损伤的ＭＲＩ改变主要为：（１）椎前血肿形成和前纵韧带断裂；（２）椎体前缘撕脱性骨折；（３）椎间盘突出。颈髓损伤的ＭＲＩ改变包括：（１）水肿；（２）出血；（３）受压。大多数病（３４／４３）采用颈前路减压术。经６～６５个月，平均３８个月随访，获得满意疗效。作者指出，急性颈椎间盘突出是过伸性颈椎损伤后多见的颈椎结构损伤，除了脊髓中央综合征外，前脊髓损伤和严重脊髓损伤也可见于过伸性颈髓损伤。ＭＲＩ对过伸性颈髓损伤的诊断和治疗方法选择具有重要价值。文中根据临床表现和ＭＲＩ检查结果，提出了在治疗方法选择方面应掌握的基本原则。

Diagnosis and treatment of hyperextension injuries of cervical spine and spinal cord

Diagnosis and treatment of 43 patients with hyperextension injuries of the cervical spine and the cord were reported. Magnetic resonance imaging(MRI) was conducted in all patients and the results showed that MRI could display the structural injuries and degree of spinal cord damage after hyperextensoin injuries of cervical spine. According to the clinical and MRI findings,both surgical and nonsurgical treatments were selected. Follow-up of 41 of them for 6 to 65 months(averaging 38 months) showed that excellent and good results in 90. 2% (37/41). The authors point out that MRI is very helpful to diagnosing ,selecting treatment and reliably predicting prognosis for cervical hyperextension injuries. Anterior cervical surgery can provide satisfactory results in patient with acute disc herniation and spinal cord injury of cervical spine.Author' s address(Department of Orthopedics ,Changzheng Hospital,Shanghai, 200003)