急性颈椎脊髓损伤的影像学诊断与手术疗法

Diagnosis and surgical treatment of acute fracture of the cervical spine complicated with spinal cord injury

１２３例急性颈椎脊髓损伤中，ＭＲＩ检查４６例。其中９２例经颈前路于损伤节段施行减压和植骨融合术；１８例行单开门椎管扩大成形加活页侧椎板间植骨术；１３例行椎板切除减压，其中５例行“Ｈ”形植骨。术后随访４个月至３ａ，以临床症状、体征和影像检查评价其效果。结果：按照Ｆｒａｎｋｅｌ功能分级法，术后神经功能提高１级以上者占８７．２％。提示：ＭＲＩ对急性颈椎脊髓损伤早期诊断、预后判断及治疗方法的选择提供了可靠的依据；及时施行解除对脊髓压迫的手术疗法，有助于神经功能的恢复。

Of the 123 cases of acute fracture of cervical spine complicated with spinal cord injury,46 cases were examined with MR imaging.92 cases were treated with decompression and bone grafting on the injured segment,18 cases with unilateral open-door method of laminoplasty and bone grafting on the intervertebral laminae,and 13 cases with laminectomy.The follow-up of 4 months to 3 years was made.The results were evaluated with the criteria of Frankel.The postoperative improvement rate was 87.2 per cent.It is suggested that MRI may provide a reliable basis for the diagnosis in early stage,the judgment of prognosis,and the selection of therapeutic method for acute fracture of the cervical spine complicated with spinal cord injury.