CAJ | 학술논문

目的：探讨无骨折脱位型急性中央型脊髓损伤治疗方法。方法32例急性中央型颈脊髓损伤患者，上肢型17例，四肢型15例。入院后行颅骨牵引、制动、脱水。20例行手术治疗，12例行非手术治疗。结果32例患者均无严重手术并发症发生，29例患者伤后3月-18月获随访，未见手术并发症发生，神经功能（ASIA法分类）均获1～2级的恢复。23例患者工作，生活可自理，颈椎MRI复查，14例患者有不同程度的脊髓空洞影像学表现。结论对无颈椎病、颈椎间盘突出、颈椎管狭窄、椎管内无梗阻的急性中央型脊髓损伤（水肿型）宜采用非手术治疗。对脊髓的持续存在致压物或颈椎失稳的中央型脊髓损伤患者应及时行手术减压，重建颈椎稳定性。对脊髓前方致压物患者采用经颈前路手术治疗，对颈椎管广泛狭窄宜采用颈后路椎管扩大成形术，对颈胸交界处颈椎管扩大成形术患者宜采用内固定。
목적：탐토무골절탈위형급성중앙형척수손상치료방법。방법32례급성중앙형경척수손상환자，상지형17례，사지형15례。입원후행로골견인、제동、탈수。20례행수술치료，12례행비수술치료。결과32례환자균무엄중수술병발증발생，29례환자상후3월-18월획수방，미견수술병발증발생，신경공능（ASIA법분류）균획1～2급적회복。23례환자공작，생활가자리，경추MRI복사，14례환자유불동정도적척수공동영상학표현。결론대무경추병、경추간반돌출、경추관협착、추관내무경조적급성중앙형척수손상（수종형）의채용비수술치료。대척수적지속존재치압물혹경추실은적중앙형척수손상환자응급시행수술감압，중건경추은정성。대척수전방치압물환자채용경경전로수술치료，대경추관엄범협착의채용경후로추관확대성형술，대경흉교계처경추관확대성형술환자의채용내고정。
Objective Explore type of acute central type spinal cord injury without fracture dislocation treatment. Methods Type of 32 cases of acute central cervical spinal cord injury patients, upper limbs of 17 cases, limbs 15 cases. Admitted to hospital after skul traction, braking, dehydration. 20 underwent surgical treatment, 12 routine non-surgical treatment. Results 32 patients had no serious complications occurred, 29 cases of patients with injury after 3 months to 18 months folow-up, no complications occurred, neural function classification method (ASIA) are 1 ~ 2 levels of recovery. 23 patients work, the life can provide for oneself, cervical spine MRI review, 14 patients had different degrees of syringomyelia imaging findings. Conclusions For cervical spondylosis, cervical intervertebral disc herniation, cervical stenosis and spinal canal without obstruction of acute central spinal cord injury (edema) appropriate USES non-surgical treatment. Continued to pressure on the spinal cord or type cervical instability in the middle of the spinal cord injury patients should be timely surgical decompression, reconstruction of cervical stability.