儿童新鲜无放射影像异常颈脊髓损伤临床分析  

Clinical analysis of fresh cervical spinal cord injury without radiographic abnormality in children

作　　者：陈立民[1] 姚猛[1] 张旗涛[1] 孙崇毅[1] 王正雷[2] 高吉昌[2] 

机构地区：[1]哈尔滨医科大学第二临床医学院骨科,黑龙江哈尔滨市150086 [2]解放军第211医院骨科,黑龙江哈尔滨市150080

出　　处：《中国康复理论与实践》2004年第12期765-766,共2页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨儿童新鲜无放射影像异常颈脊髓损伤 (SCIWORA)的临床特点及治疗。方法对 14例儿童SCIWORA(非手术治疗 13例、颈后路寰枢椎融合术 1例 )进行回顾性分析。结果本组患儿死亡 1例 ,13例获平均 3年随访 ,无明显改善者 3例 ,其余患儿肢体功能均有不同程度的恢复。根据ASIA分级标准 ,治疗前为A级 3例、B级 5例、C级 5例、D级 1例 ;治疗后恢复至B级 1例、C级 2例、D级 5例、E级 2例。结论颈椎一过性脱位造成的脊髓损伤是儿童SCIWORA的主要原因 ,神经功能恢复情况与脊髓原发性损伤程度密切相关 ,治疗以非手术方法为主 ,对存在颈椎明显不稳者可采用手术治疗。ObjectiveTo investigate the clinical characteristics and therapy of fresh cervical spinal cord injury without radiographic abnormality (SCIWORA) in children.MethodsThe materials of fourteen SCIWORA children (13 cases treated with non operative menthod, 1 case treated by atlantoocciptal fusion) were analyzed retrospectively.ResultsOne child was dead, and the other 13 cases had a 3 year follow up. Three children's symptoms had no change. According to ASIA criterion, there were 3 cases with grade A, 5 cases with grade B, 5 cases with grade C and 1 case with grade D before treatment. After treatment, there were 1 case recovered to grade B, 2 cases recovered to grade C, 5 cases recovered to grade D, 2 cases recovered to grade E.ConclusionSpinal cord injury caused by a short time dislocation of cervical vertebrae is the main reason of SCIWORA in children. The degree of the injury of spinal cord is related directly with the recovery of function of nervous system. Most patients can get satisfactory results by non operative methods. Operations are useful to the cases with obvious instability of cervical spine. [

关 键 词：放射影像 颈脊髓损伤 治疗 儿童 

分 类 号：R683.2[医药卫生—骨科学]