摘要
目的探讨退变性颈椎管狭窄外伤时脊髓损伤的临床特点及疗效。方法 2006-05/2010-06间治疗退变性颈椎管狭窄颈脊髓损伤患者24例,男15例,女9例,年龄44~73岁,平均60.5岁。致伤原因：摔伤16例,交通伤7例,暴力伤1例。神经功能按ASIA分级：A级6例,B级8例,C级6例,D级4例。狭窄原因：颈间盘突出9例,骨质增生狭窄11例,后纵韧带骨化4例。分析椎管狭窄位置及范围与颈髓MR I T2高信号变化范围、手术方式、手术前后脊髓功能变化的关系。结果退变性椎管狭窄的颈椎在较轻的外力下常可出现较严重脊髓损伤。伤后8 h内入院的13例行甲泼尼龙冲击治疗,1例死于并发症,12例患者脊髓功能有改善。手术治疗23例,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恢复,术后半年ASIA分级平均改善0.9级。结论退变性颈椎管狭窄外伤后脊髓损伤程度往往较重,狭窄位置及范围与MR I颈髓信号改变平面直接相关。甲泼尼龙冲击治疗、手术减压均有助于神经功能恢复。
Objective To investigate the clinical characteristics and results of cervical spinal cord injury（SCI） in the patients with degeneration stenosis of cervical spinal canal（DSCSC）.Methods Twenty four patients with cervical SCI associated with degeneration stenosis of cervical spinal canal were retrospectively analyzed.Data collection included preoperative and postoperative neurological funcation,position of degeneration stenosis of cervical spinal canal,MRI signal changes and surgical approaches.Result Spinal cord associated with degeneration stenosis of cervical spinal canal was injured severely by mild trauma.Methylprednisolone sodium succinate was used within 8 h after trauma in 13 cases.One of them died of complications.The neurological functions were markedly improved in the other 12cases.Twenty three cases had surgical treatment.All patients with neurological injury obtained an average improvement of 0.9 ASIA grades except for 6 cases of spinal cord completely.Conclusions The patients with degeneration stenosis of cervical spinal canal prone to have severe SCI,which directly associates with the preexisting DSCSC-location and hyperintensity signal change in the spinal cord on MRI.Both of using methylprednisolone sodium succinate administration within 8 h after trauma and surgical decompression may improve the neurological outcomes.
出处
《职业卫生与病伤》
2011年第3期158-160,共3页
Occupational Health and Damage
关键词
颈椎
脊髓损伤
椎管狭窄
cervical vertebrae
spinal cord injury
stenosis of spinal canal
