急性颈脊髓损伤的早期手术疗效
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作者Author单位AddressE-Mail
侯为林 HOU Wei-lin 南京中医药大学附属常州市中医医院骨科,江苏常州213003 Department of Orthopaedics,Changzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing Traditional Chinese Medicine University,Changzhou 213003,Jiangsu,China hwlgmhj@ yeah.net 
瞿玉兴 QU Yu-xing 南京中医药大学附属常州市中医医院骨科,江苏常州213003 Department of Orthopaedics,Changzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing Traditional Chinese Medicine University,Changzhou 213003,Jiangsu,China  
期刊信息:《中国骨伤》2006年,第19卷,第5期,第261-263页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:探讨大剂量激素冲击并早期前、后路手术减压固定治疗急性颈脊髓损伤的疗效。

方法:11例急性颈脊髓损伤患者,男7例,女4例;年龄23~63岁,平均37岁;受伤时间30min~6h。脊髓神经功能Frankel分级:A级2例,B级6例,C级2例,D级1例。早期大剂量激素冲击的同时,6例行前路减压植骨钢板内固定,3例行后路单开门椎板减压侧块钢板固定,2例先后路减压复位再前路减压植骨钢板固定。

结果:跟踪随访3~22个月,平均13个月。脊髓神经功能的恢复按Frankel分级评定,平均提高2.1级,其中A→B1例,A→C1例,B→C2例,B→D3例,B→E1例,C→E2例,椎间融合率100%,无内固定松动发生。

结论:早期大剂量激素冲击积极手术内固定可获得彻底地减压、有效防止脊髓继发损伤,植骨融合率高,稳定性好。
【关键词】颈椎  脊椎损伤  外科手术
 
Early operation of acute cervical spinal cord injury
ABSTRACT  

Objective:To explore the effect of application of a large quantity of glucocoriticoids combined with early anterior and posterior decompression and fixation for the treatment of acute cervical spinal cord injury.

Methods:Eleven patients(7 male and 4 female;The average age of 37 years ranging from 23 to 63 years;Time of injury from 30 min to 6 hours)with acute cervical spinal cord injury were treated with large quantity of glucocoriticoids and surgical operation.According to Frankel degree,the neurological function were evaluated:grade A in 2 cases,grade B in 6 cases,grade C in 2 cases and grade D in 1 case.Meanwhile,among them 6 were operated upon by anterior decompression,bone grafting and internal plate fixation,3 were operated upon by posterior expansive open-door laminoplasty decompression and side plate fixation,and 2 were operated upon by posterior decompression,reduction,anterior decompression,bone grafting,and anterior plate fixation.

Results:All patients were followed up for 3 to 22 months (13 months on average).The neurological improvement of 2.1 Frankel degree on average was evaluated and included A→B in 1 case,A→C in 1 case,B→C in 2 cases,B→D in 3 cases,B→E in 1 case,C→E in 2 cases.100% solid fusion was obtained in the bone-grafting interface.No internal loose.

Conclusion:The positive early operation with internal fixation method and application of a large quantity of glucocoriticoids can help to obtain a complete decompression,to prevent effectively complications,to improve solid fusion of bone-grafting and obtain good reliability.
KEY WORDS  Cervical vertebrae  Spinal cord injuries  Surgical operative,procedures
 
引用本文,请按以下格式著录参考文献:
中文格式:侯为林,瞿玉兴.急性颈脊髓损伤的早期手术疗效[J].中国骨伤,2006,19(5):261~263
英文格式:HOU Wei-lin,QU Yu-xing.Early operation of acute cervical spinal cord injury[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(5):261~263
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