无骨折脱位型颈髓损伤的治疗

Treatment of spinal cord injury without fracture or dislocation

目的探讨无骨折脱位型颈髓损伤治疗方式及手术时机选择。方法回顾性分析62例无骨折脱位型颈髓损伤患者的临床资料：非手术治疗12例,受伤1周内行手术治疗39例,受伤8~26 d行手术治疗11例;经随访比较治疗前后ASIA分级的变化。结果经12~48个月随访,非手术治疗者症状改善比例为91.67%,1周内手术者症状改善比例为87.18%,1周后手术者症状改善比例为54.55%;经χ2检验,3组比较差异有统计学意义（P〈0.05）。结论 1周内手术及非手术治疗疗效优于1周后手术,但非手术治疗需严格选择病例才能达到满意疗效。

Objective To explore the outcome in the management of cervical spinal cord injury without fracture or dislocation,and the timing of the operation.Methods Sixty-two cases with cervical spinal cord injury without fracture or dislocation were retrospectively divided into 3 groups and analyzed intensively.One group contained 12 non-operative cases with the other group of which involved 39 operative treatment within 7 days,while 11 cases were distributed to the third group which received operation in the period of 8~26 days.ASIA classification over injury and follow-up data were utilized to analyze the different outcome of the 3 groups.Results After followed up for 12 to 48 months,the rate of clinical improvement in non-surgical treatment group was 91.67%,while the one of the surgery within 1 week group was 87.18%,and 54.55% in the group of surgery in 1 week.With χ2 test,there was significant statistical difference between 3 groups（P0.05）.Conclusions The clinical outcome of the surgery within 1 week group and the non-surgical treatment group are better than that of surgery after 1 week group.However,non-surgical treatment needs to be rigorously pondered in order to achieve favorable results.