上颈椎损伤引起的交叉麻痹

Cruciate Paralysis Caused by Injury of the UpperCervical Spine

交叉麻痹是一种发生于颈脊髓一延髓交界部的少见损伤。本文报告５例由上颈椎损伤所引起的交叉麻痹，占同期收治１６８例上颈椎损伤的２．９８％。此损伤的主要特点为双侧上肢麻痹而下肢症状轻微或不受累。其病理机制可能为延髓与颈脊髓交界处锥体束交叉纤维的选择性受损，如能及时治疗多预后良好。本组５例中１例行后路减压及枕颈融合术，另４例均行保守治疗，结果４例恢复正常，１例接近正常。

AbstractCruciate paralysis also called Bll’s cruciateparalysis, is an uncommon condition caused by injuryof the cervical spine,at the cervicomedullary junction。Five patients with injuries of the upper cervical spineand the clinical manifestation of cruciate paralysis werepresented.They were found among the 168 cases ad-mitted into the authors’hospital during January 1975to December 1992 ,for 2.98%of the total admissionof the upper cervical spine injury;The clinical patternwas characterized bv bilateral upper extremity paraly-sis,with minimal or no lower extremity involvement.The mechanism was probably selective injuries at thecrossing fibers of the cervical spinaI tracts at the cervi-comedullary junction, With timely treatment of thecervical injury,the prognosis is satisfactory.One casein this group had posterior decompression and cervicalspine fusion,and the other 4 cases were treated withtraction and plaster of Paris immobilization. A satisfactory recovery was seen in all.