下颈椎损伤分类评分系统的临床应用  

Clinical application of the sub-axial cervical spine injury classification system

作　　者：朱烨[1] 何登伟[1] 陈剑[1] 刘飞俊[1] 吴忠伟[1] 朱科军[1] 俞伟杨[1] 盛孝永[1] 

机构地区：[1]温州医科大学附属第五医院丽水市中心医院脊柱外科,浙江丽水323000

出　　处：《临床骨科杂志》2016年第2期144-146,共3页Journal of Clinical Orthopaedics

基　　金：丽水市科技局科技计划项目(编号:2012JYZB92)

摘　　要：目的评估SLIC评分系统对下颈椎损伤治疗的指导作用。方法对76例下颈椎损伤患者行颈椎X线、CT、MRI检查和系统的神经学体检,按照SLIC系统的原则对骨折形态、间盘韧带复合体（DLC）状态和神经功能状态3个方面进行评估。根据影像学检查将骨折形态分为：无异常、压缩型、爆裂型、牵张型和旋转/平移型;将DLC损伤分为：无损伤型、不确定型、断裂型;根据神经学体检将神经损伤状态分为：无损伤、神经根损伤、完全性/不完全性脊髓损伤和持续脊髓压迫损伤。根据SLIC评分系统选择治疗方法,评估患者的神经功能恢复情况和并发症发生情况。结果 76例均获得随访,时间9~22（12.6±1.2）个月。15例评分≤4分的患者选择非手术治疗,其中有4例评分=4分者转为手术治疗;8例评分=4分及53例评分≥5分的患者均选择手术治疗。治疗后除6例脊髓完全性损伤者神经功能无好转外,其余患者神经功能均有不同程度的改善。结论 SLIC评分系统具有较高的可靠性,且使用简单,易于掌握,此方法对于颈椎损伤的评估较全面和准确,可以作为患者临床治疗选择的依据。Objective To evaluate the effect of sub-axial cervical spine injury classification（ SLIC） system on the treatment of sub-axial cervical spine. Methods 76 patients with sub-axial cervical spine were selected. All patients underwent cervical spine X-ray,CT,MRI and neurological examination. All patients were evaluated according to the principle of SLIC system,including fracture morphology,disco-ligamentous complex（ DLC） damage,and neurological status. According to the imaging examination,the fracture morphology was divided into： no damage,compression type,burst type,distraction type and rotation / translation type; DLC damage was divided into： intact,indeterminate,and disrupted. According to the neurological status,the state of nerve injury was divided into： intact,nerve root injury,complete / incomplete spinal cord injury and continuous spinal cord compression injury. According to the SLIC scoring system,the treatment method was selected,the recovery of neurological function and complications was evaluated. Results 76 patients were followed up for 9 ~ 22（ 12. 6 ± 1. 2） months. 15 cases with scores≤4 points were chosen conservative treatment. 4 cases with scores equal to 4 points chosen conservative treatment finally turned to surgical treatment. 8 cases of patients with scores equal to 4 points and 53 cases with scores≥5 points were selected for surgical treatment. The neurological function of the patients were improved after treatment except 6 patients with complete spinal cord injury. Conclusions SLIC scoring system has high reliability,and is simple and easy to master. This method can be used in the evaluation of cervical spine injury,which can be used as a basis for the choice of clinical treatment.

关 键 词：脊柱损伤 下颈椎损伤分类评分系统 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]