贵州医科大学学报

2016, v.41;No.190(07) 829-832

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Ⅰ型无骨折脱位型颈髓损伤经颈前路手术与非手术治疗效果比较
Comparison of Clinical Effect of Anterior Cervical Surgery and Non-Surgical Treatment in Patients with Type Ⅰ SCIWORA

杨磊落;李青;彭吾训;王春庆;潘廷;肖正亮;安平江;
YANG Leiluo;LI Qing;PENG Wuxun;WANG Chunqing;PAN Ting;XIAO Zhengliang;AN Pingjiang;Department of Orthopedics,the Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:比较Ⅰ型无骨折脱位型颈髓损伤(SCIWORA)行颈前路手术与非手术治疗的疗效。方法:86例Ⅰ型SCIWORA患者分成手术组(62例)和非手术组(24例),手术组患者根据受损椎间盘节段数量,43例行经颈前路单节段椎间盘摘除及椎间植骨融合内固定术;19例行经颈前路椎体次全切除、双节段病变间盘摘除及椎间植骨融合内固定术,非手术组常规给予甘露醇、激素、营养神经等对症治疗,分别在治疗后2周、4周、3个月、6个月、1年采用JOA评分比较两组患者脊髓功能改善情况,治疗后1年,采用ASIA评分比较两组患者神经功能改善情况。结果:治疗后4周、3个月、6个月、1年两组患者JOA评分差异均有统计学意义(P<0.05),手术组脊髓功能改善率优于非手术组;治疗后1年,两组患者ASIA评分差异有统计学意义(P<0.05),手术组神经功能改善率优于非手术组。结论:Ⅰ型SCIWORA经颈前路手术治疗后脊髓功能和神经功能恢复良好,疗效满意,值得进一步临床推广。
Objective: To compare clinical effect of anterior cervical surgery and non-surgical treatment in adult patients with type I SCIWORA. Methods: 86 cases of patients with SCIWORA were divided to two groups,of whom 62 cases went to surgery group and 24 cases went to non-surgical group.JOA score was adopted to evaluate recovery of spinal cord function 2 weeks,4 weeks,3 months,6months and 1 year after corresponding treatment in the two group. ASIA was adopted to evaluate recovery of neurological function in both groups after 1 year of treatment. Results: JOA score of two groups were significantly different 4 weeks,3 months,6 months and 1 year after treatment( P < 0. 05),and the recovery rates of spinal cord function in surgery group was better than those in non-surgical group.ASIA score of two groups was significantly different after 1 year of treatment( P < 0. 05),and the recovery rates of neurological function in surgery group were better than those in non-surgical group.Conclusion: The recovery in spinal cord function and neurological function is good after anterior cervical surgery in patients with type I SCIWORA. Anterior cervical surgery is worthy of further application in clinic.

关键词(KeyWords): 脊髓损伤;外科手术;随访;神经功能
spine cord injuries;surgical procedures,operative;follow up;nerve function

Abstract:

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基金项目(Foundation): 贵州省科技合作计划项目[黔科合LH字(2014)7149]

作者(Author): 杨磊落;李青;彭吾训;王春庆;潘廷;肖正亮;安平江;
YANG Leiluo;LI Qing;PENG Wuxun;WANG Chunqing;PAN Ting;XIAO Zhengliang;AN Pingjiang;Department of Orthopedics,the Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2016.07.021

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