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。
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. Resuits：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.
出处
《中国骨伤》
CAS
2006年第5期261-263,共3页
China Journal of Orthopaedics and Traumatology
关键词
颈椎
脊椎损伤
外科手术
Cervical vertebrae
Spinal cord injuries
Surgical operative, procedures
作者简介
通讯作者：侯为林 Tel：0519-8133123 E-mail：hwlgmhj@yeah.net
