56例无骨折脱位型颈髓损伤手术疗效分析

To study the treatment outcome of surgical operation about 56 cases cervical spine injuries without fracture and dislocation

目的 :探讨无骨折脱位型颈髓损伤早期手术治疗效果。方法 :自 1996年收集我院 5 6例无骨折脱位颈髓损伤病人。入院后给予 MRI和 X线检查 ,其中后纵韧带骨化 17例 ,特发性弥漫性骨肥厚症 4例 ,黄韧带骨化 8例 ,颈椎管狭窄 15例 ,其中 2 3例于伤后 3d内手术。19例为晚期手术 ,14例保守治疗。结果 :早期手术满意 ,较大于 72 h手术与保守治疗的效果明显改善 (P<0 .0 5 ) ,术后未见颈椎不稳与再关门 ,所有病人均在入院后进行 Frankel分级 ,2 w后出院再次评分 ,早期手术组改善率明显高于其他两组 ,X线显示颈椎内径增加 ,椎管扩大 MRI显示颈椎后侧减压明显。结论 :无骨折脱位型颈髓损伤早期正确诊断 。

Objective:To evaluate the treatment outcome of early surgery operative about cervial spine injuries without fracture and dislocation.Methods:56 patients of cervical spine injuries with no fracture and dislocation had undergone the MRI and X-ray,OPLL(17 cases),DCS (15 cases),CSM(4 cases),23 cases in 3 days,19 cases in 2 mouths and 14 cases without operated.Results:51 cases had been followed up for an average of 1 years,The result of the early surgery were analyzed.when the operation were over 72 hours,the results were disappointed.Instabilily of the Cervical spine on Frankel grading scale after surgery plain.X-ray film showed the increase of sagital diameter of cervical spinal canal.CT scan showed the en alrgement of cervical spinal canal.MRI showed the backward movemant decompression of cervical spinal cord.Conclusion:Both enlargement of cervical spinal canal and decompression of spinal cord can be obtainted by expanstily opening door laminoplasty clinical result was saitsfactory.following the above mentioned procedure,the early opration was very importment factors for the better outcome.