【摘要】 目的探讨早期手术干预对急性不完全颈脊髓损伤的疗效及手术方式的选择。方法对2003年1月至2014年5月第二军医大学长征医院闸北分院收治的462例不完全颈脊髓损伤患者进行回顾性分析,其中手术组387例(颈前路减压植骨融合内固定术283例,前后路联合手术26例,单纯后路减压术78例),非手术组75例。颈脊髓损伤神经功能恢复按Frankel分级和美国脊髓损伤协会(ASIA)评分标准进行评估。结果随访12~27个月,432例患者Frankel分级有不同程度改善,改善率为93.51%,手术组改善率(381例,98.45%)高于非手术组(51例,68.00%)。各组治疗后ASIA评分均较治疗前提高(P<0.05);对各组治疗前后ASIA评分的差值进行比较,手术组ASIA评分差值大于非手术组(P<0.05),而且前路手术和前后路联合手术ASIA评分差值大于单纯后路手术(P<0.05)。结论急性不完全颈脊髓损伤宜早期外科干预,以促进神经功能恢复。更多还原

【Abstract】 Objective To discuss the clinical efficacy of early surgical intervention of acute incomplete cervical spinal cord injury and the selection of operative modes.Methods The clinical data of 462 patients incomplete cervical spinal cord injury,who were treated in our hospital from January 2003 to May 2014 were analyzed retrospectively.There were 387 cases in the operation group(283received anterior cervical decompression and bone graft fusion and internal fixation,26 received anterior and posterior decompression,and 78 received simple posterior decompression)and 75 cases in non-operative group.The neurological function recovery of cervical spinal cord injury was evaluated by Frankel classification and ASIA scoring criteria.Results The patients were followed up for 12-27 months.The results showed that the Frankel classification was improved to different degrees in 432 cases,with an improvement rate of 93.51%.The improvement rate of operative treatment group was98.45%,which was higher than that of the non-operative group(68.00%).The ASIA scores of both groups were increased after treatment(P<0.05),and the increase in the operation group was greater than the non-operation group(P<0.05).In addition,the ASIA improvement of the anterior and anterior plus posterior approach surgery was greater than that of the simple posterior approach surgery(P<0.05).Conclusion Early surgical intervention should be given to acute incomplete cervical spinal cord injury so as to promote the neuronal function recovery.更多还原