颈椎管扩大成形术在治疗无骨折脱位型颈脊髓损伤中的作用

Expansive laminoplasty as a method for managing cervical spinal cord injury coincident with no fracture and dislocation

目的:探讨颈椎管扩大成形术治疗无骨折脱位型颈脊髓损伤的临床疗效。方法:对24例无骨折脱位型颈脊髓损伤患者行颈椎管扩大成形术,早期进行康复训练,比较患者在治疗前后ASIA评分及改善率,并与10例保守治疗者进行对比。结果:两组在治疗后感觉及运动功能较治疗前有明显提高(P<0.05)。但手术组疗效明显优于保守治疗组(P<0.01)。结:论对无骨折脱位型颈脊髓损伤患者早期施行减压及稳定手术可取得比保守治疗更好的效果。线锯法颈椎管扩大成形术结合早期康复训练为无骨折脱位型颈脊髓损伤的治疗与功能恢复提供了新的思路。

Objective:To investigate the efficacy of expansive laminoplasty for the treatment of cervical spinal cord injury coincident with no fracture and dislocation.Method:24 patients(all men) with cervical spinal cord injury coincident with no fracture and dislocation were managed with expansive laminoplasty using the T-saw to open the spinous process and 10 patients were managed with conservative treatment.The follow-up period ranged from 2 months to 23 months.ASIA score system was used to measure the severity of SCI and recovery rates.Result:All patients had some recovery after surgical and conservative treatment(P<0.05).But there was higher recovery rate in surgical treatment than in conservative(P<0.01). Conclusion:For cervical spinal cord injury coincident with no fracture and dislocation,the effect of early surgery treatment is superior to conservative.T-saw laminoplasty combining with early rehabilitation are appropriate methods for the treatment of cervical spinal cord injury coincident with no fracture and dislocation.