Ⅰ型无骨折脱位型颈髓损伤经颈前路手术与非手术治疗效果比较  

Comparison of Clinical Effect of Anterior Cervical Surgery and Non-Surgical Treatment in Patients with Type Ⅰ SCIWORA

作　　者：杨磊落[1] 李青[1] 彭吾训[1] 王春庆[1] 潘廷[1] 肖正亮[1] 安平江[1] 

机构地区：[1]贵州医科大学附院骨科,贵州贵阳550004

出　　处：《贵阳医学院学报》2016年第7期829-832,共4页Journal of Guiyang Medical College

基　　金：贵州省科技合作计划项目[黔科合LH字(2014)7149]

摘　　要：目的:比较Ⅰ型无骨折脱位型颈髓损伤(SCIWORA)行颈前路手术与非手术治疗的疗效。方法:86例Ⅰ型SCIWORA患者分成手术组(62例)和非手术组(24例),手术组患者根据受损椎间盘节段数量,43例行经颈前路单节段椎间盘摘除及椎间植骨融合内固定术;19例行经颈前路椎体次全切除、双节段病变间盘摘除及椎间植骨融合内固定术,非手术组常规给予甘露醇、激素、营养神经等对症治疗,分别在治疗后2周、4周、3个月、6个月、1年采用JOA评分比较两组患者脊髓功能改善情况,治疗后1年,采用ASIA评分比较两组患者神经功能改善情况。结果:治疗后4周、3个月、6个月、1年两组患者JOA评分差异均有统计学意义(P<0.05),手术组脊髓功能改善率优于非手术组;治疗后1年,两组患者ASIA评分差异有统计学意义(P<0.05),手术组神经功能改善率优于非手术组。结论:Ⅰ型SCIWORA经颈前路手术治疗后脊髓功能和神经功能恢复良好,疗效满意,值得进一步临床推广。Objective：To compare clinical effect of anterior cervical surgery and non-surgical treat-ment in adult patients with type I SCIWORA. Methods：86 cases of patients with SCIWORA were di-vided to two groups,of whom 62 cases went to surgery group and 24 cases went to non-surgical group. JOA score was adopted to evaluate recovery of spinal cord function 2 weeks,4 weeks,3 months,6 months and 1 year after corresponding treatment in the two group. ASIA was adopted to evaluate recovery of neurological function in both groups after 1 year of treatment. Results：JOA score of two groups were significantly different 4 weeks,3 months,6 months and 1 year after treatment（P﹤0.05）,and the recovery rates of spinal cord function in surgery group was better than those in non-surgical group. ASIA score of two groups was significantly different after 1 year of treatment（ P﹤0.05 ）,and the re-covery rates of neurological function in surgery group were better than those in non-surgical group. Conclusion：The recovery in spinal cord function and neurological function is good after anterior cervical surgery in patients with type I SCIWORA. Anterior cervical surgery is worthy of further application in clinic.

关 键 词：脊髓损伤 外科手术 随访 神经功能 

分 类 号：R683.2[医药卫生—骨科学]