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颈椎迟发性过伸性损伤合并脊髓损伤的临床研究

[Clinical research of delayed hyperextension injury concomitance spinal cord injury of cervical spine].

作者信息

Kang Hui, Jia Lian-shun, Zhou Xu-hui, Gu Xiao-min, Shi Guo-dong, Fang Jia-hu

机构信息

Department of Orthopaedics, Changzheng Hospital, the Second Military Medical University, Shanghai, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Jul 15;46(14):1062-5.

Abstract

OBJECTIVE

To discuss Clinic feature and turnover of delayed hyperextension injury concomitance spinal cord injury of cervical spine.

METHODS

The clinic data of 30 patients delayed hyperextension injury of cervical spine were reviewed and analyzed. Course of disease was from 3 months to 8 years. Thirty patients were divided into three groups according to course of disease. The first group, 3 - 6 months, 17 cases; the second group, 6 - 12 months, 8 cases; the third group, 12 months-8 years, 5 cases. Neurological function improvement rates were evaluated according to the JOA scores at preoperative, 3 months and 1 year post operation, and complications were observed in three groups. Twenty-six cases were treated with anterior decompression, bone graft and plate fixation. Four cases were treated with posterior decompression, bone graft and plate fixation.

RESULTS

The patient number of the three group exist with statistical significance. Thirty patients were followed up for 18 - 39 months, 23 months on average. Neurological function recovery rates were 23.8% in the first group, 53.9% in the second group and 54.3% in the third group at 1 year post operation. JOA scores of the first group and the second group with statistical significance at 3 months and 1 year post operation. JOA scores of the first group and the third group with statistical significance at 3 months and 1 year post operation. JOA scores of the second group and the third group without statistical significance at 3 months and 1 year post operation.

CONCLUSIONS

Incidence of hyperextension injury associated with spinal cord injury of cervical spine would degrade along with course of disease prolong. If delayed spinal cord injury occurred earlier, the patient's condition was severer and badly improvement rate.

摘要

目的

探讨颈椎过伸性损伤合并脊髓损伤的临床特点及疗效。

方法

回顾性分析30例颈椎过伸性损伤患者的临床资料,病程3个月至8年。将30例患者按病程分为三组。第一组,病程3 - 6个月,17例;第二组,病程6 - 12个月,8例;第三组,病程12个月 - 8年,5例。根据术前、术后3个月及1年的JOA评分评估神经功能改善率,并观察三组并发症情况。26例行前路减压、植骨融合钢板内固定术,4例行后路减压、植骨融合钢板内固定术。

结果

三组患者例数存在统计学差异。30例患者随访18 - 39个月,平均23个月。术后1年第一组神经功能恢复率为23.8%,第二组为53.9%,第三组为54.3%。术后3个月及1年第一组与第二组JOA评分有统计学差异;术后3个月及1年第一组与第三组JOA评分有统计学差异;术后3个月及1年第二组与第三组JOA评分无统计学差异。

结论

颈椎过伸性损伤合并脊髓损伤的发生率随病程延长而降低。脊髓损伤发生时间越早,病情越重,恢复率越差。

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