急性颈髓中央损伤的诊断与治疗
Diagnosis and treatment of acute central cervical cord injury.
作者信息
Dai L, Jia L, Ni B, Yuan W, Liu H, Hou T, Zhao D, Xu Y
机构信息
Department of Orthopaedics, Changzheng Hospital, Shanghai, China.
出版信息
Chin Med J (Engl). 1998 Apr;111(4):351-3.
OBJECTIVE
To clarify the diagnosis and management of acute central cervical cord injury.
METHODS
Eighty-nine patients with acute cervical central cord injury were retrospectively reviewed. Sixty-three patients were treated conservatively and 26 were treated surgically. There were two acute deaths. Eighty-seven patients were followed up for 3 months to 15 years.
RESULTS
Their average neurological score (ASIA) was increased from 41.7 at admission to 83.1 at follow-up.
CONCLUSIONS
Acute central cervical cord injury should be differentiated from complete spinal cord injury, cervical myelopathy, cruciate paralysis and C8 nerve root injury. When compression of nerve tissue or cervical instability is identified, operative intervention should be indicated. The prognosis is less optimistic in the patients with severe primary injury and at old age.
目的
明确急性颈髓中央损伤的诊断与处理方法。
方法
回顾性分析89例急性颈髓中央损伤患者。其中63例采用保守治疗，26例接受手术治疗。有2例急性死亡病例。87例患者随访3个月至15年。
结果
患者的平均神经功能评分（美国脊髓损伤协会评分）从入院时的41.7提高至随访时的83.1。
结论
急性颈髓中央损伤应与完全性脊髓损伤、颈椎病性脊髓病、交叉性瘫痪及C8神经根损伤相鉴别。当发现神经组织受压或颈椎不稳定时，应进行手术干预。原发性损伤严重及老年患者的预后不太乐观。
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