摘要
目的 探讨SLIC评分系统在指导治疗下颈椎损伤中的作用.方法 自2007年5月至2009年2月基于SLIC评分系统治疗34例下颈椎损伤患者,男21例,女13例;平均年龄31.5岁.损伤节段：C42例,C5 1例,C6 1例,C3-42例,C4-5 4例,C5-6 11例,C6-7 9例,C7～T11例,C3-5 1例,C4-6 1例,C6～T1 1例.受伤至手术时间1～30 d,平均7.1 d.神经功能按美国脊髓损伤协会（ASIA）分级：A级6例,B级17例,C级7例,D级3例,E级1例.根据SLIC评分系统评分：1分1例,3分1例,4分1例,5分3例,6分5例,7分6例,8分13例,9分3例,10分1例.2例〈4分的患者采用非手术治疗;1例等于4分和31例〉4分的患者依据SLIC评分系统中损伤形态学不同结合椎间盘韧带复合体损伤和神经功能状况选择前路、后路或前后联合入路手术治疗. 结果 34例患者术后随访7～18个月,平均11.5个月.2例保守治疗者骨折愈合,神经根性损害恢复,颈痛缓解.32例手术患者植骨均在6～9个月内融合,椎间高度和生理曲度无明显异常.治疗后除6例脊髓完全性损伤者神经功能无明显变化外,其余患者神经功能均有不同程度的改善,ASIA分级平均改善1.1级.本组无切口感染、内固定松动或断裂、椎体塌陷、假关节形成、神经损害等并发症发生.结论 SLIC评分系统简便、易于掌握,在其指导下对颈椎损伤进行手术与非手术治疗具有重要意义.
Objective To explore the role of Sub-axial Injury Classification （SLIC） scoring system in the treatment of sub-axial cervical spine injury. Methods From May 2007 to February 2009, 34 patients with lower cervical spine injury were admitted into our department. They were 21 males and 13 females, with an age average of 31. 5 （range, 21 to 61 ） years. The causes for injury included traffic accident in 19 cases, fall in 11, direct violence in 2 and sports in 2. By American Spinal Injury Association （ASIA） criteria, the neurologic function was graded as A in 6 cases, as B in 17, as C in 7, as D in 3 and as E in one. The 2 cases of less than 4 SLIC points received conservative treatment, one case of 4 SLIC points and 32 cases of more than SLIC 4 points received surgical treatment through anterior approach, posterior approach, or combined anterior-posterior approach. All cases were followed up and the therapeutic effects were evaluated based on SLIC points. Results The 2 cases having conservative treatment obtained fracture healing and pain relief, and the 32 cases having surgical treatment showed good bone fusion between 6 and 9 months and good maintenance of the intervertebral height and cervical curvature. All patients with neurological injury obtained an average improvement of 1. 1 ASIA grades. Conclusion SLIC scoring system is easy and plays a positive role in guiding conservative and surgical treatments of sub-axial cervical spine injury, leading to satisfactory results.
出处
《中华创伤骨科杂志》
CAS
CSCD
2010年第5期425-428,共4页
Chinese Journal of Orthopaedic Trauma
关键词
颈椎
创伤和损伤
治疗
Cervical spine
Wounds and injuries
Treatment
