合并颈椎疾病的无骨折脱位颈脊髓损伤的治疗策略  

Treatment strategies of without fracture and dislocation of cervical spinal cord injury combined with cervical disorders

作　　者：朱庄臣[1] 焦伟[1] 蔡国栋[1] 张辉[1] 王俊勤[1] 

机构地区：[1]泰山医学院附属医院骨科,山东泰安271000

出　　处：《中国现代医学杂志》2014年第2期83-86,共4页China Journal of Modern Medicine

摘　　要：目的探讨合并颈椎疾病的无骨折脱位颈脊髓损伤的治疗策略及疗效。方法回顾2005~2012年收治的41例合并各种颈椎疾病的无骨折脱位颈脊髓损伤病例,根据治疗情况分为手术组及非手术组,观察两组患者治疗前后JOA评分改变情况。结果 41例无骨折脱位颈脊髓损伤患者中,合并颈椎管狭窄21例,颈椎病15例,颈椎后纵韧带骨化5例。其中手术患者24例,非手术患者17例。手术组采用前路减压15例,后路减压9例,所有病例未发生血管、神经损伤等严重并发症。非手术组采取牵引、激素及脱水药物等治疗。治疗前后JOA评分及改善率对比均有统计学意义（P〈0.05）。结论对合并颈椎疾病的无骨折脱位型颈脊髓损伤患者,根据患者年龄、退变程度、临床症状体征及影像学检查,有针对性地选择个性化治疗方案,可以获得较满意的治疗效果。[ Objective ] To explore the treatment strategy and the efficacy of without fracture and disloca- tion of cervical spinal cord injury combined with cervical disorders. [Method] 41 cases of without fracture and dislocation of cervical spinal cord injury combined with cervical disorders were reviewed since 2005 to 2012. The patients were divided into operation group and the non-surgery group, according to the therapeutic situation and the JOA score change of two groups were observed before and after treatment. [Results ] In the 41 cases of cervical spinal cord injury without fracture and dislocation, 21 cases combined with cervical stenosis, 15 cases of cervical spondylosis, and cervical posterior longitudinal ligament in 5 cases. 24 patients received operation and 17 with non-surgery treatment. 15 cases were treated with anterior decompression and 9 with posterior decompression in the operation group. All cases did not occur with blood vessels, nerve in- jury and other serious complications. Patients in the non-surgical group were treated with skull traction, hor- mones and dehydration medication. After follow-up, the JOA score and the improving rate had statistical sig- nificance （P 〈0.05）. [Conclusion] It can achieve more satisfactory therapeutic effect for patients without frac- ture and dislocation of cervical spinal cord injury combined with cervical disorders, while reliable selection of individualized treatment procedure is based on the patient＇s age, the degree of degeneration, the clinical signs and symptoms and imaging findings.

关 键 词：颈椎 无骨折脱位 颈脊髓损伤 

分 类 号：R681.55[医药卫生—骨科学]