创伤性颈脊髓中央综合征的治疗观察

TREATMENT OF CENTRAL CERVICAL CORD INJURY

目的：观察创伤性颈脊髓中央综合征的治疗效果。方法：分析我院2007年1月至2008年12月收治的创伤性颈脊髓中央损害综合征患者25例。伤后7-10天内手术17例（A组），伤后1-3月手术8例（B组）；无骨折脱位17例、伴颈椎骨折脱位8例、伴颈椎管狭窄11例。结合手术前颈椎X线、CT、MR／检查及术前和术后第6月ASIA（American Spinal InjuryAssocia—tion）评分进行分析。结果：所有患者术后均获随访，平均随访8月。①经手术治疗后，所有患者脊髓神经功能均得到了明显恢复。评分有统计学意义（P〈0．05）；②伤后7-10天内手术组患者术后6月ASIA评分明显高于伤后1-3月手术组，评分有统计学意义（P〈0．05）。结论：①因无骨折脱位型CCS伴颈椎管狭窄的患者缺乏明显的X线、CT表现，容易漏诊与误诊；②CCS患者早期手术解除颈脊髓压迫，稳定颈椎，有助于脊髓神经功能的恢复。

Objective：To study the therapeutic effects on central cervical cord injury. Methods：25 cases with central cervical cord injury were retrospectively analyzed.They were divided into earlier operative group（treatment began 7-10 days after injury） （n= 17） and later operative group（1-3 months after injury） （n=8）. Preoperative and 6 months postoperative ASIA （American Spinal Injury Association） Standard Neurological Classification of Spinal Cord Injury were performed to make a comparison between the two groups. Results：The followed-up varied from 6 months to 12 months, with an average of 8 months.①All the patients＇ spinal cord function was significantly recovered after operation （P〈0.05）. ②The ASIA score of earlier later operative group （P〈0.05）. Conclusions： ①The misdiagnosis happened due to lack of visible evidence in radiological examination. ②The earlier decompress and fixation operation after damage is helpful to the recovery of spinal cord function.