急性脊髓损伤显微髓内减压手术治疗研究

Therapeutic effect of early intradural microsurgery on acute spinal cord injury

目的探讨急性脊髓损伤后早期行显微髓内减压手术的疗效及手术时机。方法对36例完全性脊髓损伤48 h内的患者在传统手术方法(脊柱内固定、硬膜外减压)的基础上,采用显微神经外科技术对受损脊髓进行髓内减压。结果术中术后未出现大出血、神经症状加重、髓内感染及肺栓塞、死亡等严重并发症。术后3个月,部分患者的美国脊柱损伤协会(American Spinal Injury Association,ASIA)残损分级较术前明显改善:B级6例、C级5例、D级3例。ASIA评分均较术前提高:平均运动提高15.25分、轻触觉提高13.47分、针刺觉提高12.88分。结论显微髓内减压手术作为一种安全的治疗方式,对于急性脊髓损伤患者的神经功能恢复有一定的促进作用。

Objective A novel intradural microsurgery for acute spinal cord injury was introduced, and the effect and timing were analyzed. Methods A total of 36 patients with complete spinal cord injury were collected and treated with the new intradural mierosurgery within 48 h, in addition to traditional surgical interventions （internal fixation, laminectomy）. Results Complications including massive hemorrhage, infection, impairment aggravation and death did not occur during or after surgery. There were 6 cases of Grade B, 5 eases of Grade C, 3 eases of Grade D according to the American Spinal Injury Association （ASIA） impairment scale 3 months after operation, and average 15.25 of increase in motor score, 13.47 in light touch score, and 12. 88 in pin prick score were achieved. Conchlsion It is safe and effective to perform early intradural microsurgery which improves part of spinal cord function in some patients.