无骨折脱位型颈脊髓损伤治疗分析

Therapeutic analysis of non-fracture and dislocation injury of cervical spinalcord

目的探讨无骨折脱位型颈脊髓损伤保守与手术疗效差别以及手术时机的选择。方法对1996年10月～2002年1月收治的无骨折脱位型颈脊髓损伤45例疗效进行探讨。结果保守治疗病例脊髓功能恢复程度低。而手术治疗病例脊髓功能恢复程度较高,并且越早手术脊髓功能改善率越高。手术均采用颈后路单开门椎管扩大成形术。结论手术治疗效果明显优于保守治疗,伤后1个月内手术效果最佳,伤后至手术时间越长,效果越差。

Objective To explore the differences between the conservative treatment and the operative treatment in the management of cervical spinal cord injury, and the timing of the operation. Methods The therapeutic effectiveness o f the 45 cases who were treated from October 1996 to January 2002 was analyzed. 21 of them underwent conservative treatment and 24 operative treatment. The corr elation between the therapeutic effects of the operation and its timing was expl ored. Results The myeloid functional recovery was poor in the patients who had b een treated with conservative means but good in those who had been given an oper ation. The earlier the operation, the more effective it could be, and the higher the probability of the myeloid functional recovery. Conclusions The operative treatment promises better outcome than the conservative treatment. To get the be st effects, the operation should be done within one month after the injury, for the longer the lapse between the injury and the operation, the worse the effect.