【摘要】 目的分析颈脊髓中央管综合征手术治疗的预后影响因素。方法回顾性分析自2010-06—2014-06行手术治疗并获得随访的52例颈脊髓中央管综合征的临床及影像学资料。采用多元回归分析评估年龄、病变节段数、是否存在椎前高信号、脊髓内高信号的范围、椎管最狭窄处百分比(MCC)、脊髓最大受压缩程度(MSCC)、入院ASIA评分、受伤至手术时间及手术入路对术后神经功能恢复情况的影响。结果 52例均获得随访(25.6±13.4)个月,未出现脊髓损伤、内固定失败等影响预后的并发症。末次随访时52例神经功能均得到一定恢复,ASIA运动功能评分为(89.4±11.7)分,其中上肢(42.4±7.6)分,下肢(47.0±4.7)分。年龄(P=0.019)及入院时ASIA评分(P<0.001)是影响预后的主要因素,而受伤至手术时间(P=0.162)、手术入路(P=0.773)、髓内有无高信号(P=0.647)、椎前有无高信号(P=0.106)、MCC(P=0.254)、MSCC(P=0.397)、病变节段数(P=0.806)与预后无明显相关性(P>0.05)。结论颈脊髓中央管综合征采用手术治疗安全有效,高龄及入院时ASIA评分较低患者神经功能恢复较差。MRI T2像脊髓内高信号的范围越广提示受伤越严重。更多还原

【Abstract】 Objective To analyze the predictors of outcome of surgical treatment for cervical central cord syndrome.Methods Fifty-two cases of cervical central cord syndrome surgically treated in our hospital from June 2010 to June 2014 were restrospectively studied. Multi-regression method was used to analyze the correspondence between age, number of skeletal segments, the existence of high signal in the front of vertebral body, length of intramedullary hyperintensity, maximum canal compromise(MCC), maximum spinal cord compression(MSCC), ASIA motor score on admission, the interval from injury to surgery, surgical approaches and the neurological outcome. Results All the 52 cases were followed up for an average of25.6 ±13.4 months, no complications affecting the prognosis, such as spinal cord injury and fixation failure were found. The neurologic function of the 52 cases at the time of last follow-up was improved. The mean ASIA motor score at the last followup was 89.4±11.7(upper extremities 42.4±7.6 and lower extremities 47.0±4.7). Age(P =0.019) and admission ASIA motor score(P <0.001) were the main factors influencing the prognosis. No statistical significance was found between neurologic outcome and the interval from injury to surgery(P =0.162), surgical approaches(P =0.773), the existence of high signal in the front of vertebral body(P =0.106), length of intramedullary hyperintensity(P =0.647), MCC(P =0.254), MSCC(P =0.397), number of skeletal segments(P =0.806). Conclusion Surgical treatment of cervical central cord syndrome is safe and effective, aged patients and those with lower admission ASIA motor score have poor functional recovery. The length of intramedullary hyperintensity in MRI is the strongest predictor of the degree of spinal cord injury.更多还原