颈椎病手术中脊髓损伤的原因及处理

The pathogenesis and treatment of spinal cord injuries in cervical spondylosis surgery

目的探讨颈椎病术中脊髓损伤的原因及处理方法。方法我科2005年3月至2007年10月手术治疗279例颈椎病,对术中出现脊髓损伤的5例患者的临床资料进行回顾性分析。结果279例患者中5例发生脊髓损伤,发生率为1.79%。颈前路颈椎病手术中发生4例,后路单开门颈椎管扩大成形术中发生1例。经过清除血肿,甲基强的松龙等药物的及时治疗,5例患者逐渐恢复。结论颈椎病前、后路手术中均可能发生脊髓损伤,如能及时治疗,预后较好。

Objective To analyse the risk factors and prevention strategies of spinal cord injury in cervical spondylosis surgery. Methods Two hundred and seventy - nine cases treated from March 2005 to October 2007 were retrospectively reviewed. Results Five of the 279 eases developed the complication of spinal cord injury, and the incidence was 1.79%. In this study, spinal cord injury in the anterior surgery in 4 cases and 1 in the cervical posterior one - door expansive laminoplasty. All the 5 cases of the spinal cord injury recovered gradually through some measures such as removing hematoma, application of mythylprednisolone, etc. Conclusion During either anterior decompression or postdrior open - door laminoplasty of cervical spondylosis, the spinal cord injury can develop. Generally speaking, patients with postoperative spinal cord injury can be cured by urgent measures, and the prognosis is satisfactory.