脊柱骨折脱位合并脊髓损伤的早期治疗

Early treatment of spinal fracture and dislocation combined with spinal cord injury

目的:探讨脊柱骨折脱位合并脊髓损伤的早期治疗方法及临床效果。方法:收治脊柱骨折脱位合并脊髓损伤患者68例,所有患者均在伤后早期大剂量应用地塞米松,进行相应手术治疗,术后随访12～24个月,末次随访时采用ASIA神经功能分级标准评价患者神经功能恢复情况。结果:68例患者均获得完整随访,神经功能恢复达到优47例,达到良15例,优良率91.18%;脊髓完全损伤患者神经功能恢复优良率61.54%,脊髓不完全损伤患者恢复优良率98.18%,不完全损伤患者的神经功能恢复优良率明显高于完全损伤患者(P<0.05)。结论:对脊柱骨折脱位合并脊髓损伤患者进行早期治疗能最大限度恢复神经功能,而且不完全脊髓损伤患者的预后质量更高。

Objective:To explore the early treatment and clinical effect of spinal fracture and dislocation combined with spinal cord injury.Methods:68 patients spinal fracture and dislocation combined with spinal cord injury were selected,all patients were treated with high-dose dexamethasone in the early post-traumatic period and corresponding surgical treatment,postoperative follow-up ranged from 12 to 24 months,at the last follow-up,ASIA neurological grading criteria were used to evaluate the recovery of neurological function.Results:All 68 patients were followed up completely,the recovery of neurological function was excellent in 47 cases,good in 15 cases,and the excellent and good rate was 91.18%,the excellent and good rate of nerve function recovery in patients with incomplete injury was significantly higher than that in patients with complete injury(P<0.05).Conclusion:Early treatment for spinal fracture and dislocation combined with spinal cord injury can restore nerve function to the maximum extent,and the prognosis of patients with incomplete spinal cord injury was better.