胸脊柱脊髓损伤的治疗

Treatment of Thoracic Spine and Spinal Cord Injury

目的总结胸脊柱脊髓损伤的临床特点,分析细胞移植治疗临床试验的入选标准.方法对1990年10月～2005年10月收治的72例胸脊柱脊髓损伤患者的临床资料进行回顾性分析.结果平均随访时间20个月（6～48个月）,12例脊髓完全损害ASIA A级均无恢复,仅4例有尿淋漓者症状好转;52例伴骨折脱位全瘫患者仅有5例恢复为B级,主要为感觉平面下降2～3个节段,余无恢复,恢复率9.6%;8例不全瘫患者恢复率62.5%;嗅鞘细胞移植患者感觉功能恢复明显,优于运动功能恢复,痉挛瘫有所改善.结论胸脊柱脊髓损伤全瘫率高,神经功能恢复差;细胞移植临床试验的入选标准为无残留压迫的陈旧性胸脊髓完全性损伤.

Objective To analysis the clinical features of thoracic spine and spinal cord injury （SCI） and summarize the inclusive standard of cellular transplant clinical trial for SCI. Methods The data of 72 cases with thoracic spine and spinal cord injury from 1990 to 2005 were analyzed retrospectively. Results Mean follow-up period was 20 months （6-48 months）. There was no recovery in 12 spinal cord injury without radiographic abnormality （SCIWORA） patients, but improvement of urine function in 4 cases. 5 cases of 52 fracture-dislocation complete injury were improved to grade B （sense recovery）, rate of recovery was 9.60% recovery rate was 62.5% in incomplete injury. Sense recovery of all cases was better than motor recovery. Partial cases appeared spasm paralysis relief. Conclusion Incidence rate of complete injury is high and recovery is bad in thoracic spine and spinal cord injury. The inclusive standard of cellular transplant clinical trial for SCI is old complete thoracic spinal cord injury without residual compression.