无骨折脱位型急性颈脊髓损伤的发病机制及治疗

The Mechanism of Cervical Cord Injury withoutFracture and Dislocation and its Management

共收治无骨折脱位型急性颈脊髓损伤病人４４例。行ＭＲＩ检查的１８例影像显示：脊髓损伤信号８９％位于间盘水平，且存在间盘损伤。分析表明：两种机制造成了脊髓的损伤，一是脊髓受到了一过性挫伤，二是脊髓受到突出间盘的压迫。根据损伤机制及治疗的需要，进一步将本病分为两型，一型为一过挫伤型，二型为间盘突出型。前者需保守治疗，后者应行手术治疗。对３４例非手术治疗病人肌力恢复的半定量评价，为本病进一步手术治疗的疗效判定提供了参照资料。

AbstractEighteen of the forty-four patients with acutecervical spinal cord injury without fracture anddislocation underwent MRI study.The results revealedthat 89%of the spinal cord injury signals appeared inthe disk level.This suggested that, the spinal cordinjuries occurred by means of either one of the twomechanisms:transient contusion or compression by theherniated disk to the spinal cord.On the basis of themechanism of injury,and the demand of themanagement,the condition was classified into twotypes:the transient contusion type and the diskherniation type。The former needs conservativetreatment and the later should be operated upon。Asemi-quantitative analysis of the myodynamic recoveryfor 34 patients given conservative treatment provideddata of reference for the therapeutic evaluation ofoperative treatment。