颈中央脊髓损伤综合征手术时间点与疗效的相关性

Relationship of operation time point with therapeutic effect in central cervical spinal cord injury syndrome

目的探讨颈中央脊髓损伤综合征伤后至手术时间与手术疗效的相关性。方法回顾性分析2007年3月—2011年3月接受手术治疗并获得随访的31例颈中央脊髓损伤综合征患者，根据伤后至接受手术的时间分为2组：早期手术组（伤后7d内手术，共14例）和晚期手术组（伤后7d以后手术，共17例）。检测入院时、术后半年及末次随访时的日本骨科学会（Japanese Orthopedic Association，JOA）评分及改善率，比较手术前后JOA评分。比较两组JOA改善率，分析伤后至手术时间与JOA改善率的相关性。结果所有患者均获得12～25个月[（16．1±4．5）个月]随访。所有患者的神经功能均获得不同程度的恢复；早期手术组随访时JOA改善率均优于晚期手术组（P〈0．01）；伤后至手术时间与随访时的JOA改善率呈负相关（r=-0．763，P〈0．01）。结论颈中央脊髓损伤综合征伤后至手术时间与手术疗效呈负相关，早期手术疗效优于晚期手术，伤后至手术时间越短，手术疗效可能越好。

Objective To evaluate the correlation of interval from injury to surgery with outcome for central cervical spinal cord injury syndrome. Methods A retrospective analysis was done for 31 patients with central cervical spinal cord injury syndrome treated surgically between March 2007 and March 2011. According to the timing of surgical intervention, the patients were divided into early operative group （ 〈7 days from injury, n = 14） and late operative group （≥7 days from injury, n = 17）. Japanese Or- thopedic Association （JOA） score on admission, at postoperative half-year and at final follow-up were re- corded and compared between the two groups. JOA recovery rate was determined and analyzed for correla- tion with operation time point. Results Mean follow-up was （16. 1 ＋ 4. 5 ） months （range, 12-25 months）. All patients had different degree of neurological recovery. JOA recovery rate in early op- erative group was apparently better than that in late operative group at final follow-up （ P 〈 0.01 ）. JOA recovery rate at follow-up was negatively correlated with intervals between injury and surgery （r = - 0. 763, P 〈 0.01 ）. Conclusion For patients with central cervical spinal cord injury syndrome, time from injury to surgery is negatively correlated with outcome, indicating that early surgery may be associated with better outcomes.