未发现压迫的创伤性非一过性脊髓损伤

Traumatic Intransient Spinal Cord Damage without Compression

未发现压迫原因的非一过性脊髓损伤在脊髓创伤中较为少见。作者1984年至1994年间对423例脊髓损伤中22例此类损伤作随访分析，对其诊断、治疗及可能发生的原因进行探讨。认为：（1）MRI能显示脊髓伤后的早期变化，对预后及治疗有重要的指导意义。（2）除了过伸损伤，其它损伤机制也能导致此类损害。（3）脊髓血管损伤、出血、髓内代谢产物沉积在这类损伤产生过程中占重要地位。（4）非手术治疗与单纯椎管减压术疗效比较无意义，而借助手术显微镜的髓内外联合减压术对该类损伤的恢复有一定帮助，即使完全性脊髓损伤亦不能轻易放弃积极治疗。

The intransient spinal cord damage withoutcompression is seldom occured in spinal cord trauma. 22cases with such damage, out of 423 spinal cord injury cases were followed up and their diagnosis, treatment,and probable etiology were analysed from 1984 to 1994.(1) MRI can reveal the early changes of spinal cordinjury and it is important for estimating the prognosisand determining the treatment; (2) Such damage can be induced by hyperextension injury and other mechanism;(3) Vascular injury, hemorrhage, and intramedullarydeposit of metabolic product are playing important rolesin the process of such damage; (4) There is no significantdifference of therapeutic effect between non-operativetreatment and simple spinal canal decompression. Thecombination of intramedullary and extramedullarydecompression under operating microscope isadvantageous to the recovery of such damage. The activetreatment could not be abandoned, even in the completespinal cord damage.