摘要
目的探讨治疗外伤性颈髓损伤手术时机选择的问题。方法自2006年2月至2008年7月的外伤性颈髓损伤64例患者,分为无骨折脱位型和骨折脱位型两组,给予糖皮质激素、脱水消肿、营养神经等药物治疗,骨折脱位型给予牵引复位,两组均行手术治疗,分别对术前和随访1年时Frankel分级进行比较。结果本组所有患者随访12-38月,平均19月。定期复查X线片了解内固定位置及骨愈合情况,所有患者最后一次X线片均显示达到骨性愈合,愈合时间为3-7月,平均为3.5月,显示颈椎高度无明显丢失,颈椎生理曲度无明显减小或消失,未见植骨块、椎间融合器脱落、钉板松动、拔出,开门后关门等情况发生。按Frankel分级进行评价神经恢复情况,骨折脱位型颈髓损伤优良率为80.5%,无骨折脱位型颈髓损伤优良率为82.6%。结论颈髓损伤后,早期积极应用药物治疗,阻断继发性损害的进一步发展,预防并发症的出现,于1-2周后全身状况稳定时行手术治疗,可以更好的促进颈髓损伤恢复。
Objective To explore the opportunity of surgical intervention for cervical traumatic spinal cord injury.Methods From Feb.2006 to July 2008,64 patients with cervical traumatic spinal cord injury were divided into two groups： the patients in the first group had no fracture and dislocation,and those in the second group had fracture and dislocation.All patients were given glucocorticoid,deprivation,detumescence,trophic nerve,surgical intervention.The patients in the second group were also treated with traction reduction.Neurological function（Frankel grade） was evaluated before and after operation.Results All cases were followed up for 19 months on average（from 12 to 38 months）.All patients were healed after 3.5 months on average.The X-ray showed that intervertebral heights and physiologic curves were well kept and there were no bone block and no plate/cage break or loose.According to Frankel system,80.5% cases obtained excellent and good effects in the second group,and 82.6% cases obtained excellent and good effects in the first group.Conclusion Medication should be used early after cervical traumatic spinal cord injury,to interdict more damage and to prevent complications.Surgery after 1-2 weeks of injury may improve neurologic recovery.
出处
《骨科》
CAS
2011年第2期73-75,共3页
ORTHOPAEDICS
关键词
脊髓损伤
外科手术
治疗
Spinal cord injuries
Surigical procedures
Therapy
