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[接受椎板切除术患者脊柱枪伤的预后因素]

[Prognostic factors related to gunshot wounds to the spine in patients submitted to laminectomy].

作者信息

Flores L P, Nascimento Filho J de S, Pereira Neto A, Suzuki K

机构信息

Unidade de Neurocirurgia do Hospital de Base do Distrito Federal, Brasília, DF.

出版信息

Arq Neuropsiquiatr. 1999 Sep;57(3B):836-42. doi: 10.1590/s0004-282x1999000500016.

Abstract

The spinal trauma related to civilian gunshot missile still remains a serious neurological event that carries a dismal prognosis almost in all cases. Its surgical indication also is a matter of discussion. Our goal is to identify the aspects that could influence the prognosis after surgery to this kind of lesions. We conducted a retrospective study of 45 consecutive patients submitted to laminectomy at Hospital de Base do Distrito Federal (Brasília, Brazil), testing the following aspects: initial neurological status, level of the deficit, surgical timing, use of methilprednisolone and presence of dural tearing. Among those, the initial clinical presentation and the level of the lesion (60% of the patients with cauda equina syndrome and 53% of that with lesions in the lombar region improved their neurological status after laminectomy) were the most important factors affecting the outcome. Seventy percent of the patients experienced a pain relief after the surgical procedure.

摘要

与民用枪伤导弹相关的脊柱创伤仍然是一个严重的神经学事件,几乎在所有病例中预后都很糟糕。其手术指征也是一个有争议的问题。我们的目标是确定可能影响这类损伤手术后预后的因素。我们对巴西联邦区基础医院(巴西巴西利亚)连续45例行椎板切除术的患者进行了一项回顾性研究,测试了以下方面:初始神经状态、缺损水平、手术时机、甲基强的松龙的使用以及硬脑膜撕裂的存在情况。其中,初始临床表现和损伤水平(60%的马尾神经综合征患者和53%的腰椎区域损伤患者在椎板切除术后神经状态得到改善)是影响预后的最重要因素。70%的患者在手术后疼痛得到缓解。

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