摘要
背景:胸腰椎损伤非常常见,但是目前尚缺乏一种实用的分类方法。目的:寻找一种符合临床治疗和预后判断的治疗方法。设计、时间及地点:探索性实验,病例来自2003-12/2005-12十堰市太和医院脊柱外科。对象:选择胸腰椎损伤患者87例,男56例,女31例,年龄18～72岁。方法:对所有类型胸腰椎损伤的患者进行研究和分析,根据其神经损伤表现及影像学特点将胸腰椎损伤根据NCS标识分类法(N:神经功能分级;C:脊柱椎管损伤程度;S:脊柱生物力学稳定性)统一标识分类,再根据治疗及随访后的预后情况将已经标识分类的损伤类型划分严重度,并以此形成统一的标准。主要观察指标:神经功能级别恢复情况。结果:87例胸腰椎损伤患者均得到随访并进入结果分析。轻度胸腰椎损伤患者11例神经功能级别均完全恢复。中度胸腰椎损伤患者,有3种类型,Ⅰ型患者26例,神经功能级别均完全恢复24例;Ⅱ型患者1例完全恢复功能;Ⅲ型患者4例不恢复及完全恢复各1例,另外2例神经功能恢复超过2级。重度患者45例,神经功能很难恢复超过2级。结论:实验设想的这种NCS标识分类法根据临床治疗和预后情况确定每一型损伤的严重度,符合临床需要,具有较高的可信度、可重复性、临床适用性。
BACKGROUND： Thoracolumbar injury is very common, but there is not a practical classification. OBJECTIVE： To formulate a unified method of injury severity and prognosis for thoracolumbar injury. DESIGN, TIME AND SETTING： An exploratory experiment, the clinical data were obtained from Department of Spine Surgery, Taihe Hospital from December 2003 to December 2005. PARTICIPANTS： A total of 87 patients with thoracolumbar injury were selected, including 56 males and 31 females, with the age of 18-72 years old. METHODS： All patients with thoracolumbar injury were analyzed according to their nerve injury manifestation and image results. A new classification is introduced, based on the treatment and follow-up of the patients, which is called NCS-sign-grouping （N： neurologic function grade; C： spinal canal deformity; S： biomechanical stability）. It is hoped to form a unified standard for thoracic-lumbar spine injury. MAIN OUTCOME MEASURES： The conditions of neurological functional recovery were observed. RESULTS： All patients were included in the final analysis. 11 cases with mild thoracolumbar injury were complete recovered. Cases with medium thoracolumbar injury including type Ⅰ, 24 cases in 26 were complete recovered; type Ⅱ, 1 case was complete recovered; type Ⅲ, 1 hardly recovered and 1 complete recovered, the other 2 cases were recovered over 2 grades. In the 45 cases with severe thoracolumbar injury, the neural function hardly recovered than 2 grades. CONCLUSION： The NCS-sign-grouping with reliability, repeatability and applicability is more useful in clinical work, which is favorable for the treatment and judgment of prognosis.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第2期376-379,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
