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无骨折脱位型急性外伤性颈髓中央综合征的治疗
Hits: 2630   Download times: 1350   Received:September 26, 2008    
作者Author单位UnitE-Mail
夏青 XIA Qing 枣庄枣矿集团中心医院骨外科,山东 枣庄 277011 Department of Orthopaedics,the Central Hospital of Zaozhuang Coal Mining Group Co.,Ltd,Zaozhuang 277011,Shandong,China wiseqing@126.com 
魏振 WEI Zhen 枣庄枣矿集团中心医院骨外科,山东 枣庄 277011 Department of Orthopaedics,the Central Hospital of Zaozhuang Coal Mining Group Co.,Ltd,Zaozhuang 277011,Shandong,China  
江海良 JIANG Hai-liang 枣庄枣矿集团中心医院骨外科,山东 枣庄 277011 Department of Orthopaedics,the Central Hospital of Zaozhuang Coal Mining Group Co.,Ltd,Zaozhuang 277011,Shandong,China  
李利昕 LI Li-xin 枣庄枣矿集团中心医院骨外科,山东 枣庄 277011 Department of Orthopaedics,the Central Hospital of Zaozhuang Coal Mining Group Co.,Ltd,Zaozhuang 277011,Shandong,China  
王森 WANG Sen 枣庄枣矿集团中心医院骨外科,山东 枣庄 277011 Department of Orthopaedics,the Central Hospital of Zaozhuang Coal Mining Group Co.,Ltd,Zaozhuang 277011,Shandong,China  
冯涛 FENG Tao 枣庄枣矿集团中心医院骨外科,山东 枣庄 277011 Department of Orthopaedics,the Central Hospital of Zaozhuang Coal Mining Group Co.,Ltd,Zaozhuang 277011,Shandong,China  
贾静 JIA Jing 枣庄枣矿集团中心医院骨外科,山东 枣庄 277011 Department of Orthopaedics,the Central Hospital of Zaozhuang Coal Mining Group Co.,Ltd,Zaozhuang 277011,Shandong,China  
期刊信息:《中国骨伤》2009年22卷,第2期,第130-132页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:分析无骨折脱位型急性外伤性颈髓中央综合征的临床治疗疗效,探讨其治疗方法。

方法: 回顾性分析47例无骨折脱位型急性外伤性颈髓中央综合征患者的临床资料,男44例,女3例;年龄46~73岁,平均56.2岁。脊髓神经功能Frankel分级,B级30例,C级14例,D级3例。对于脊髓有明确的外在致压因素或损伤节段不稳的5例采用手术治疗,其中前路手术3例,后路手术2例,非手术治疗42例。对其致伤原因、致伤机制、影像学表现、神经功能损伤程度、治疗方法及临床疗效进行分析。

结果:6例失访,非手术治疗死亡2例。39例术后随访3~84个月,平均12个月。治疗后3个月内,非手术7例出现并发症,但两组患者后期均有不同程度的肢体神经痛。多数病例遗留手内在肌功能不同程度的损害。

结论:根据病情及影像学资料灵活选择治疗方案,保守和手术均可取得良好的治疗结果。
[关键词]:脊髓损伤  中央综合征  颈椎  外科手术
 
Clinical treatment of acute traumatic central cervical spinal cord syndrome without fracture and dislocation
Abstract:

Objective: To analyze clinical characteristics and therapeutic efficacy of acute traumatic central cervical spinal-cord syndrome without fracture and dislocation,and to investigate its treatment methods.

Methods: Clinical data of 47 cases with acute traumatic central cervical spinal-cord syndrome without fracture and dislocation were retrospectively analyzed. There were 3 female and 44 male,with a mean age of 56.2 years(ranging from 46 to 73 years). According to Frankel classification,30 cases were grade B,14 cases were grade C and 3 cases were grade D. Forty-two cases were treated without operation,and 5 cases which had significant compression factors or segmental instability were treated with surgical treatment. Among them,3 cases were treated through anterior approach and 2 cases were treated through posterior approach. Causes of injuries, mechanisms of injuries,findings of imaging,functional impairment of nerve,methods of treatment,and therapeutic efficacy were analyzed.

Results: The average followed-up time was 12 months (ranging form 3 to 84 months),2 cases of non-operation were dead and 6 were loss. Three months after treatment,some complications occurrenced on 7 patients of non-operation. The majority bequeathed different degree impairment of intrinsic muscles of hands.

Conclusion: Reduction and fixation through the pedicle of fractured vertebra is an effective therapeutic options to treat the thoracolumbar burst fractures and desearved clinical study and expansion.
KEYWORDS:Spinal cord injuries  Central cord syndrome  Cervical vertebrae  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:夏青,魏振,江海良,李利昕,王森,冯涛,贾静.无骨折脱位型急性外伤性颈髓中央综合征的治疗[J].中国骨伤,2009,22(2):130~132
英文格式:XIA Qing,WEI Zhen,JIANG Hai-liang,LI Li-xin,WANG Sen,FENG Tao,JIA Jing.Clinical treatment of acute traumatic central cervical spinal cord syndrome without fracture and dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(2):130~132
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