无骨折脱位型颈髓损伤手术与非手术治疗疗效对比观察

Comparative observation on operative and non-operative effects in treatment of cervical spinal cord injury without fracture dislocation

目的 比较无骨折脱位型颈髓损伤非手术与手术治疗后 ,脊髓功能恢复程度的差异。 方法 回顾性分析 2 4例无骨折脱位型颈髓损伤患者 ,其中 13例行手术治疗 ,11例行非手术治疗 ,根据损伤时日本骨科学会 (JOA)评分、治疗后随访JOA评分 ,比较治疗前后JOA评分增加幅度。 结果 治疗后 3个月JOA评分增加幅度 :非手术组为 1.6 4± 0 .5 8,手术组为 3.2 9±0 .90 ;治疗后 12个月JOA评分增加幅度 :非手术组为 2 .0 0± 0 .73,手术组为 4 .93± 0 .96。经t检验 ,两组差异均有非常显著性意义 (P <0 .0 1)。 结论 无骨折脱位型颈髓损伤手术治疗效果明显优于非手术治疗 ,无骨折脱位型颈髓损伤一旦确诊 ,应当积极争取早期手术。

Objective To compare the difference of function regain level of spinal cord after operative or non-operative treatments of cervical spinal cord injury without fracture dislocation. Methods Twenty-four cases with cervical spinal cord injury without fracture dislocation were retrospectively analyzed and divided into operative treatment group ( n =13) and non-operative treatment group ( n =11). JOA (Japanese Orthopaedic Association) scores at injury and during follow-up were recorded to make a comparison between operative treatment group and non-operative treatment group before and after treatment. Results JOA scores three months after treatment were 1.64±0.58 in the non-operative group and 3.29 ±0.90 in the operative treatment group. JOA scores 12 months after treatment were 2.00± 0.73 in the non-operative group and 4.93±0.96 in the operative treatment group. There was a significant difference statistically between both groups through t test ( P <0.01). Conclusions For the cervical spinal cord injury without fracture dislocation,the operative treatment is superior to the non-operative treatment. Once the verified diagnosis is done,the operative treatment should be carried out as early as possible.