摘要
目的探讨无骨折脱位型颈脊髓损伤的手术治疗方法与效果。方法我科自2000年10月至2007年10月手术治疗无骨折脱位型颈脊髓损伤21例,其中单节段椎间盘突出4例,双节段椎间盘突出10例,三节段及多节段突出7例,合并椎体后缘骨赘6例,黄韧带肥厚5例,先天性椎体融合2例。合并先天性和发育性颈椎管狭窄9例。致压物主要来源于脊髓前方的单节段、二节段压迫脊髓,采用颈前路椎体次全切除减压自体髂骨植骨融合、带锁钛板内固定术14例。三节段及以上多节段压迫脊髓,采用颈后路单开门或双开门颈椎管扩大椎板成型术7例。结果 21例经平均30个月随访,2例完全性颈脊髓损伤术后难以忍受胸腹部束带感缓解,但四肢肌力、大小便功能无恢复。19例按JOA评分,术前平均5.58分,术后提高到11.46分。结论无骨折脱位型颈脊髓损伤,根据脊髓致压部位节段争取早期手术治疗,选择适当的手术方法,可较好地改善脊髓功能,提高病人的生活质量。
Objective To investigate the method and effect of surgical treatment for non .fracture-dislocation of cervical spinal cord injury. Methods 21 patients with no fracture dislocation cervical spinal cord injury were underwent surgical treatment,among them four eases were single segment discintervertebral disk hernia,10 cases were two disc segment intervertebral disk hernia,7 cases were three paragraphs and multi segment intervertebral disk hernia,6 cases of combined posterior marginal osteophytes, 5 cases of hypertrophy ligamentum flavum,congenital vertebral fusion in 2 cases. And development and congenital neck Spinal stenosis in 9 cases. Compression was mainly caused by objects in front of the spinal cord,a single segment or two segments of spinal cord compression. Using ante-cervical approach sub-total removal of cervical vertebrae for decompression and fusion with autologous iliac bone graft,locking by titanium plate fixation in 14 cases. Using posterior approach single open-door or both cervical spinal canal expansion Laminectomy plasty for three or more paragraphs and multi-segment spinal cord compression in 7 cases. Results 21 patients received an average of 30 months follow-up, 2 patients with complete cervical spinal cord injury patients with belted excruciating sense of chest and abdomen were released ,but the limbs ,muscle strength ,toilet functions didnot recover. 19 cases by JOA estimating,preoperative average of 5.58 points,increased up to 11.46 after operation. Conclusion No fracture dislocation cervical spinal cord injury,according to segment parts of the spinal cord compression should early treated by surgical treatment ,and selecting the appropriate surgical approach may be better to improve spinal function and the quality of life of patients.
出处
《实用骨科杂志》
2011年第4期301-303,共3页
Journal of Practical Orthopaedics
关键词
无骨折脱位
颈脊髓损伤
手术治疗
no fracture dislocation
cervical spinal cord injury
surgical treatment
