无骨折脱位型颈脊髓损伤的手术治疗

Surgical treatment of cervial spinal cord injury without radiographic spinal fracture-dislocation

目的探讨无骨折脱位型颈脊髓损伤的手术方式和治疗效果。方法 2001年1月～2010年4月共收治无骨折脱位型颈脊髓损伤患者共64例,行手术治疗57例。依据患者的症状和MRI检查将手术分为前路手术、后路手术及前后路联合手术,将术前术后的JOA评分进行比较分析。结果患者定期随访,3个月～1年半,平均1年,通过对手术治疗后术前术后JOA评分进行统计学分析,P<0.05,差异有统计学意义。结论无骨折脱位型颈脊髓损伤根据脊髓受压的部位和范围选择不同的手术方式均能达到很好的治疗效果。

Objective To discuss the surgical treatment and its clinical outcomes of Cervial Spinal cord injury without radiographic spinal fracture-dislocation.Methods The clinical data of 64 patients with Cervial Spinal cord injury without radiographic spinal fracture-dislocation from 2001 to 2010.57cases with surgical treatment. According to the patient′s symptoms and MRI,the Operation mode.was divided into three types：anteriorapproach.posteriorapproachandposterior-anterior approach.Each patient′s JOA score before and after operation was reviewed.Results All cases were regularly followed up.the duration of follow up averaged two years.The JOA score of three groups after operation improved compared with that before operation（P0.05）.Conclusion According to compression segments,extent of disease,similar neurological improvement was made by the approach of anterior,posterior or anterior-posterior for SCIWORSFD.