外伤性颈椎间盘突出型脊髓损伤的治疗

Treatment of traumatic cervical disc hernia with spinal cord injury

目的:评价外伤性颈椎间盘突出型脊髓损伤手术治疗效果。方法:回顾性分析38例外伤性颈椎间盘突出型脊髓损伤患者作为手术组,均采用颈椎前路椎间盘摘除、椎体间植骨、钛板内固定术、依据Frankel分级情况及JOA改善率,并以因为各种原因出现外伤性颈椎盘突出型脊髓损伤但未手术治疗者35例作为对照组,进行组内和组间对比,评价治疗效果。结果:手术组术后Frankel分级恢复1～4个等级。术后2个月JOA改善率为59.92%,对照组Frankel分级恢复1～2个等级,术后2月JOA改善率为35.70%。组间对比显示手术组患者脊髓功能恢复程度优于保守治疗组。结论:颈椎间盘突出是无骨折脱位型颈脊髓损伤的重要病理基础,合理的前路手术能获得较理想的脊髓功能恢复效果。

Objective：To evaluate the effects of operation on traumatically cervical disc hernia with spinal cord injury.Method：A retrospective study was performed on 38 cases with traumatic cervical disc hernia with spinal cord injury.All the cases were anterior operated on with discectomy,bone graft within vertebral bodies and internal fixation with titanium template.The operative outcomes were evaluated on Frankel criterion and recovery ratio of JOA.Thirty-five cases with traumatic cervical disc hernia with spinal cord injury were treated by conservative therapy.Result：The Frankel criterion of the operation patients was recovered to grade one to four level,and the recovery ratio of JOA was 59.92% two months after the operation.The Frankel criterion of conservative therapy was recovered to grade one to two levels,and the recovery ratio of JOA was 35.70% two months after the operation.Conclusion：Hernia of cervical discs was the main pathological basis of cervical spinal cord injury without fracture and dislocation.Appropriate anterior approach can achieve good myeloid functional recovery.