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前路减压治疗下颈椎颈髓损伤并截瘫 被引量:2

Anterior decompression for lower cervical spine and spinal cord injury with paraplegia
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摘要 目的 探讨下颈椎颈髓损伤手术及疗效以及影响疗效的因素。方法 采用颈椎前路减压自体腓骨植骨融合治疗下颈椎颈髓损伤高位截瘫 36例。结果  2 8例随访 2~ 8年 ,平均 5年 7个月。按ASIA损伤分级 ,Ⅰ级 14例 ,术后无效 1例 ,术后恢复至Ⅱ级 4例 ,Ⅲ级 3例 ,Ⅳ级 4例 ,Ⅴ级 2例 ;Ⅱ级 4例 ,术后恢复至Ⅲ级 1例 ,Ⅳ级 2例 ,Ⅴ级 1例 ;Ⅲ级 6例 ,术后恢复至Ⅳ级 3例 ,Ⅴ级 3例 ;Ⅳ级 4例 ,术后全部恢复至Ⅴ级。提示伤后 8h内手术最佳时机。结论 采用颈椎前路减压植骨融合治疗下颈椎颈髓损伤效果肯定。 Objective To investigate the surgical treatment for lower cervical spine and its spinal cord injury, the effect and it's relative factors. Methods 36 cases of lower cervical spine and spinal cord injury with high paraplegia were treated with anterior decompression and autogenous fibular graft fusion. Results 28 cases were followed up for 2~8 years, 5 years and 7 months on average. According to ASIA standard neurological classification of spinal cord injury, among the 14 cases of grade Ⅰ, 1 got no recovery, 4 improved to grade Ⅱ, 3 improved to grade Ⅲ, 4 improved to grade Ⅳ and 2 improved to grade Ⅴ; among the 4 cases of grade Ⅱ, 1 improved to grade Ⅲ and 2 improved to grade Ⅳ, 1 improved to grade Ⅴ; among the 6 cases of grade Ⅲ, 3 improved to grade Ⅳ and 3 improved to grade Ⅴ; among the 4 cases of grade Ⅳ, all improved to grade Ⅴ. It showed the optimal operation time should be in 8 hours after injury. Conclusion It provides positive effect for lower cervical spine and spinal cord injury to be treated with anterior decompression and bone graft fusion.
作者 王永恒
机构地区 张掖市医院骨科
出处 《临床骨科杂志》 2004年第4期430-431,共2页 Journal of Clinical Orthopaedics
关键词 颈髓损伤 颈椎 前路减压 spinal cord injury cervical vertebrae, anterior decompression
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