无骨折脱位型颈脊髓损伤的治疗策略与疗效观察  

Treatment Strategy and Effects of Cervical Spinal Cord Injury without Radiographic Abnormality

作　　者：王文达[1] 金祺[1] 阮文枫 平安松[1] 

机构地区：[1]武汉大学中南医院骨科,湖北武汉430071

出　　处：《医学新知》2016年第1期43-45,48,共4页New Medicine

摘　　要：目的探讨无骨折脱位型颈脊髓损伤的治疗策略及疗效。方法回顾性分析我院2013年1月-2015年1月收治的42例无骨折脱位型颈脊髓损伤患者的临床资料，所有患者均由影像学资料明确诊断。采用Frankel分级和JOA评分对患者术前、末次随访的脊髓神经功能进行评价，并计算改善率和优良率。研究不同治疗方式的疗效和手术时机选择对疗效的影响，并作统计学分析。结果42例患者获得1～18个月的随访，平均9．5个月。末次随访时脊髓神经功能较术前有不同程度的改善（P〈0．05），伤后早期（〈3天）行手术治疗的患者与其他患者相较，改善率和优良率具有明显差异（P〈0．05）。结论无骨折脱位型颈脊髓损伤的患者应根据其病情及特点尽早进行手术治疗，可以获得较好的疗效。Objective To investigate treatment strategy and effects of cervical spinal cord injury without radio- graphic abnormality（CSCIWORA）. Methods A retrospective analysis was performed in 42 patients with CSCIWORA in our hospital from Jan. 2013 to Jan. 2015. All the patients were diagnosed by radiographic data. Spinal nerve func- tion was evaluated using Frankel classification and JOA score before treatment and at the final follow - up. Improve- ment rate as well as excellent and good rates were calculated. The effects of different treatments and operation timings were studied and analyzed. Results 42 patients were followed up from 1 month to 18 months with an average of 9.5 months. The spinal nerve functions were improved in different degrees at the final follow - up（ P 〈 0.05 ）. There were significant differences in improvement rate as well as excellent and good rates between patients underwent operation in early stage of injury（ 〈 3 days） and other patients （ P 〈 0.05 ）. Conclusion CSCIWORA patients should be treated with surgery according to conditions and characteristics as soon as possible to achieve good efficacy.

关 键 词：颈椎 脊髓损伤 治疗 

分 类 号：R446.5[医药卫生—诊断学]