预防性手术治疗伴有颈椎管狭窄的无骨折脱位颈脊髓损伤的评估  

Prophylactic surgery is invalid intreatment of spinal injury without fracture and dislocationcomplicated by cervical spinal canal stenosis

作　　者：李浩曦 雍之瑶 刘涛[1] 周军[1] 吴德升[1] 

机构地区：[1]同济大学附属东方医院脊柱外科,上海市200120

出　　处：《实用医学杂志》2017年第1期112-114,共3页The Journal of Practical Medicine

基　　金：国家自然科学基金资助项目(编号:81371994);浦东新区卫生系统重点学科建设资助项目(编号:PWZx2014-02)

摘　　要：目的:评估C3~4节段损伤的颈椎管狭窄(CSCS)发生无骨折脱位的创伤性颈脊髓损伤(CSCI)的风险和发生率,从而探讨该病解压手术预处理的可行性。方法:纳入2005-2012年期间治疗的83例外伤性CSCI。采用Mann-Whitney秩和检验,随后运用方差分析(ANOVA)计算与CSCS相关发生外伤性CSCI的相对度(RR值)和绝对风险度(AR值)。结果:C3~4节段损伤的CSCS患者发生CSCI的相对风险是不合并CSCS患者的145.7倍。然而,仅有0.000 026%的患者可通过手术减压预防发展至CSCI。结论:预防性手术对CSCS发展至CSCI可能是无效的。Objective In this study, we aim to evaluate the risk and incidence of traumatic cervical spinal cord injury （CSCI） in patients with traumatic cervical spinal canal stenosis （CSCS） without major fracture or dislocation, and evaluate the feasibility of preventive decompression surgery. Methods This study included eightyseven patients with traumatic CSCI without major fracture or dislocation treated in our department between 2005 and 2012. Mann-Whitney U test was used for statistical analyses. Analysis of variance （ANOVA） was used to calculate the relative and absolute risks for the incidence of traumatic CSCI without major fracture or dislocation related with CSCS. Results The relative risk for the incidence of traumatic CSCI with CSCS was 145.7 times higher than that for the incidence without CSCS. However, only 0.000026% of patients with CSCS may be able to avoid developing traumatic CSCI if they underwent decompression surgery before trauma. Conclusions Prophylactic surgical management for CSCS might not significantly affect the incidence of traumatic CSCI.

关 键 词：颈椎管狭窄 脊髓损伤 MRI 

分 类 号：R651.2[医药卫生—外科学]