中青年颈椎无骨折脱位的急性颈脊髓中央型损伤的手术效果

摘要

Objective To study the outcomes of surgeries for acute central cervical spinal cord injury without cervical spine fracture or dislocation in young and middle-aged patients. Methods The clinical data of 58 young and middle-aged patients with acute central cervical spinal cord injury treated in our hospital between August 2005 and August 2009 were analyzed retrospectively. Of these patients, 33 (24 males and 9 females) received surgical treatment and 25 (17 males and 8 females) had conservative therapy. The ASIA grade and ASIA motor and sensory score were used for evaluation at admission and at 14 days and 1 year after the treatment. The neurological symptoms and treatment outcomes in the two groups were evaluated. Results The proportion of patients with ASIA grade D-E and the ASIA motor and sensory scores were all significantly higher in the surgical group than in the non-surgical treatment group (P<0.05). Conclusion For young and middle-aged patients with central cervical spinal cord injury, immediate surgery can relieve the pressure on the injured spinal cord and improve the micro-circulation to promote functional recovery of the spinal cord.%目的 研究中青年颈椎无骨折脱位的急性颈脊髓中央型损伤的手术效果.方法 选择我院脊柱外科2005年8月～2009年8月间收治的中青年无骨折脱位型颈脊髓损伤患者中资料完整者58例,根据治疗方法不同分为手术组(33例)和非手术组(25例).分别于入院时、14d及1年随访时进行ASIA分级、ASIA运动及感觉评分.采用SPSS16.0软件完成统计分析两组神经症状改善情况,评价手术治疗效果.结果 最终ASIA分级中D-E级所占比例、运动及感觉评分,手术组均明显优于非手术组(P<0.05).结论 对中青年颈椎脊髓中央性损伤患者,存在明显的脊髓受压或MRI检查显示脊髓异常信号在1个椎体高度以上者,应尽早手术治疗.手术可以解除损伤脊髓的受压,改善其微循环,利于脊髓功能的恢复.