CAJ | 학술논문

目的：总结外科减压治疗无骨折脱位的颈脊髓损伤的临床疗效。方法2006年3月-2012年9月，共收无骨折脱位的颈脊髓损伤36例，男25例，女11例；年龄16-68岁，平均年龄41.5岁；病理基础：先天性颈椎管狭窄3例，退变性颈椎管狭窄12例，急性颈椎间盘突出7例，后纵韧带骨化4例，颈椎不稳3例，黄韧带骨化1例，椎间盘突出合并椎管狭窄3例，颈椎不稳合并椎管狭窄3例；J O A脊髓功能评分为0-7分，平均4.3分。在有效维持患者生命体征的前提下，根据不同病理基础分别采用前路减压融合、后路椎板开门椎管扩大成形、后路椎板开门椎管扩大成形结合前路减压融合、后路椎板开门椎管扩大成形结合侧块螺钉固定等手术方式进行减压治疗。结果所有患者平安度过围手术期并获得18-96月随访，平均48.6月，JOA脊髓功能评分为7-17分，平均12.8分。改善率为65.4％；优良率为78.8％。结论外科减压治疗无骨折脱位的颈脊髓损伤可取得较好的神经功能改善。
목적：총결외과감압치료무골절탈위적경척수손상적림상료효。방법2006년3월-2012년9월，공수무골절탈위적경척수손상36례，남25례，녀11례；년령16-68세，평균년령41.5세；병리기출：선천성경추관협착3례，퇴변성경추관협착12례，급성경추간반돌출7례，후종인대골화4례，경추불은3례，황인대골화1례，추간반돌출합병추관협착3례，경추불은합병추관협착3례；J O A척수공능평분위0-7분，평균4.3분。재유효유지환자생명체정적전제하，근거불동병리기출분별채용전로감압융합、후로추판개문추관확대성형、후로추판개문추관확대성형결합전로감압융합、후로추판개문추관확대성형결합측괴라정고정등수술방식진행감압치료。결과소유환자평안도과위수술기병획득18-96월수방，평균48.6월，JOA척수공능평분위7-17분，평균12.8분。개선솔위65.4％；우량솔위78.8％。결론외과감압치료무골절탈위적경척수손상가취득교호적신경공능개선。
Objective to summarize the therapeutic effect of surgical decompression treatment for cervical spinal cord injury without fracture or dislocation.Methods 36 patients with cervical spinal cord injury without fracture or dislocation were treated by surgical decompression,25males and 11 females,aged from 16 to 68 years old averaged 41.5 years old;pathology fundament:3 with inborn cervical spinal stenosis,12with degenerative cervical spinal stenosis,7with acute cervical intervertebral disk hernia, 4 with ossification of posterior longitudinal ligament,3 with cervical instability,1 with ossification of the yel ow ligament,1 with acute cervical intervertebral disk hernia and spinal stenosis,3 with cervical instability and spinal stenosis;According to spinal cord fuction scoring system of Japanese Orthopaedics Association,the score was from 0 to 7,the average score was 4.3.Under the premise of effective vital sign, according to different pathology fundament, ;patients were treated by anterior decompression fusion, posterior laminoplasty, posterior laminoplasty and anterior decompression fusion, posterior laminoplasty and lateral mass screw fixation.the improvement of nerve fuction was observed.Results Al patients pul ed through the period time of operation securely and were fol owed up from 18 months to 96months ,average48.6months , At the latest fol owed-up time,the score of JOA was from 7 to 17,the average score was 12.8.nerve improvement rate was 65.4%, fineness rate was 78.8%Conclusion decompression treatment for cervical spinal cord injury without fracture or dislocation could gain good nerve function improvement.