SLIC评分系统在无骨折脱位型颈脊髓损伤治疗中的应用

SLIC scoring system in the treatment of cervical spinal cord injury without fracture and dislocation

[目的]探讨下颈椎损伤分类（SLIC）系统在无骨折脱位型颈脊髓损伤中应用时，SLIC评分=4分患者的治疗原则。[方法]回顾性分析2009年2月-2012年2月入院的无骨折脱位型颈脊髓损伤患者临床资料，依据SLIC评分系统对每个患者进行评估，筛选出SLIC评分：4分患者，共106例。按照治疗方法不同分为保守治疗组、前入路手术组及后人路手术组，应用ASIA残损分级和JOA评分对治疗前、后脊髓功能进行评定。[结果]随访时A—SIA残损分级显示前、后入路手术组神经功能恢复优于保守治疗组，其中保守治疗组平均升级0．31，前、后入路手术组平均升级分别为0．94和0．90；JOA评分显示保守治疗组改善率和优良率分别为25．13％和25．00％，明显低于前入路手术组（51．70％，58．82％）和后入路手术组（50．02％，50．00％），且差异均具有统计学意义（P〈0．05）。[结论]SLIC评分系统在无骨折脱位型颈脊髓损伤治疗中应用时，对于SLIC评分=4分患者，应给予手术治疗，以获得较好的临床结果。

[ Objective]To explore the treatmental principle of cervical spinal cord injury without fracture and dislocation when the patient~ SLIC scores were 4 points. [ Method] Cases with cervical spinal cord injury without fracture and dislocation since February 2009 to February 2012 were retrospectively reviewed. According to the SLIC scoring system, patients whose SLIC scores were 4 points were divided into conservative treated group, anterior operated group and posterior operated group. Evalua- tion of spinal cord function based on ASIA impairment scale and JOA scores were performed at pretherapy and following up. [ Result] The results of ASIA impairment scale assessment showed neurological function improved better in anterior operated group（ improved 0.94） and posterior operated group（ improved O. 90） than in conservative treated group（ improved 0.31 ）. The results of JOA scores showed the improvement rate of JOA scores and ＂ excellent＂ or ＂ good＂ rate in anterior operated group （51.70%, 58.82% ）and posterior operated group （50.02% ,50.00% ） were better than in conservative treated group （25. 13 % ,25.00% ）, and significant difference between anterior operated group or posterior operated group and conservative treated group, （P 〈 0.05）. [ Conclusion] In the treatment of cervical spinal cord injury without fracture and dislocation, the patient whose SLIC scores are 4 points should be given the operation to achieve an efficient clinical outcome.