无骨折脱位型颈髓损伤颈前路手术与保守治疗的疗效对比  

Clinical effect of anterior cervical surgery on spinal cord injury without radiological abnormality: a comparison with conservative treatment

作　　者：徐峰[1] 李涛[2] 胡昊[1] 徐彬[2] 谭林英 张建[2] 伍博宇 席金涛 XU Feng;LI Tao;HU Hao;XU Bin;TAN Lin-ying;ZHANG Jian;WU Bo-yu;XI Jin-tao(Orthopedic Department, Wuhan General Hospital, PLA, Wuhan, 430070, China;Graduate Institute, Hubei University of Chinese Medicine, Wuhan 430065, China)

机构地区：[1]中国人民解放军武汉总医院脊柱微创外科,武汉430000 [2]湖北中医药大学研究生院,武汉430065

出　　处：《中国临床神经外科杂志》2017年第11期744-747,共4页Chinese Journal of Clinical Neurosurgery

基　　金：湖北省自然科学基金(2014CFB473);湖北省卫生计生委课题(WJ2017H0033)

摘　　要：目的对比分析无骨折脱位型颈髓损伤(SCIWORA)颈椎前路手术与保守治疗的疗效。方法回顾性分析自2011年3月至2014年3月收治的53例SCIWORA的临床资料,其中34例接受颈椎前路手术(颈前路手术组),19例行保守治疗(保守治疗组)。所有病人出院后随访15~60个月,平均26个月。治疗前、治疗后1、3、6个月及末次随访采用日本骨科协会(JOA)评分评估脊髓功能改善情况;入院时、末次随访采用美国脊髓损伤协会(ASIA)评分评估神经功能改善情况。结果治疗后1、3、6个月及末次随访,两组JOA评分较治疗前均明显改善(P<0.05),且颈前路手术组明显优于保守治疗组(P<0.05)。两组治疗后ASIA评分均较治疗前明显改善(P<0.05)。结论 SCIWORA采用颈前路手术与保守治疗均有效,但颈前路手术对脊髓和神经功能的恢复更满意,可作为首选的治疗方法。Objective To observe clinical effect of anterior cervical surgery on spinal cord injury without radiological abnormality(SCIWORA).Methods The clinical data of53patients with SCIWORA,of whom,34were treated by anterior cervical surgery and19were conservatively treated from March,2011to March,2014in our hospital,were analyzed retrospectively.The spinal cord function and neurological function after the treatment in all the patients were assessed respectively by Japanese Orthopaedic Association(JOA)score and American Spinal Injury Association(ASIA)neurological function grade before and after the treatment in all the patients.Results JOA scores were significantly higher after the treatment than those before the treatment in both the groups(P<0.05).JOA scores were significantly higher in the operative group than those in the conservative group after the treatment(P<0.05).The neurological function assessed by ASIA grade was significantly better in the operative group than that in the conservative group after the treatment(P<0.05).Conclusion The curative effect of anterior cervical surgery on the patients with SCIWORA was significantly better than that of the conservative treatment.

关 键 词：无骨折脱位型颈髓损伤 颈前路手术 保守治疗 疗效 

分 类 号：R744.9[医药卫生—神经病学与精神病学]