无骨折脱位型颈脊髓损伤的手术治疗

Surgical Treatment of Cervical spinal Cord Injury Without Fracture-dislocation

目的：探讨无骨折脱位型颈脊髓损伤的发病机制、手术方式及时机。方法：回顾性分析25例无骨折脱位型颈脊髓损伤患者的临床表现及影像学特点，根据损伤情况及影像学表现采取不同的手术方式治疗，并比较手术前后的Frankel分级。结果：本组患者随访10～36个月（平均20个月），术前Frankel分级：A级2例，B级7例，C级12例，D级4例；术后患者Frankel分级：A级1例，B级5例，C级6例，D级11例，E级2例。术后硬膜外血肿形成1例，及时手术清除后病人恢复良好。结论：退变性因素是无骨折脱位颈脊髓损伤的病理基础,及早采取手术治疗可以取得良好的临床效果。

Objective .To evaluate the etiological mechanism, reasonable surgical time and surgical approach of cervidal spinal cord injury withont fractwre-dislocution. Method： 25 patients were retrospectively analyzed of clinical manifestation and radiological feature, Frankel scoring was compared before and after operation. Result： The average follow -up was 20 months （10 -36 months）, Frankel scoring was A2, B7, C12,D4 before operation and A1, B5, C6, D11, E2 after operation. One patients occurred epidural hematoma. Conclusion： Degenerative factors was pathological cause of cervical spinal cord injung withont fracture-dislocation, good clinical outcomes can be acquired by early surgical treatment.