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颈椎脊髓损伤伴脊柱稳定行椎板成形术的结果

Outcome of laminoplasty in cervical spinal cord injury with stable spine.

作者信息

Ghasemi Amir Abbas, Behfar Behshad

机构信息

Department of Neurosurgery, Urmia Medical University, Urmia, Iran.

Department of Orthopaedic Surgery, Iran Medical University, Tehran, Iran.

出版信息

Asian J Neurosurg. 2016 Jul-Sep;11(3):282-6. doi: 10.4103/1793-5482.175638.

Abstract

BACKGROUND AND OBJECTIVE

Cervical spinal cord injury (CSCI) with a stable spine has been increasing as the elderly population is dramatically increasing all over the world. In this study, we evaluated the neurological outcome of decompression surgery (laminoplasty) for these patients.

MATERIALS AND METHODS

Forty-one patients with CSCI with stable spine who underwent decompression surgery (laminoplasty) were retrospectively studied. Inclusion criteria were as follows: CSCI without instability, spinal cord contusion in magnetic resonance image (MRI), spinal cord compression rate more than 20%, neurologic deficit American Spinal Cord Injury Association ([ASIA] scale from A to D), and follow-up of at least 12 months. Preoperative neurological state, clinical outcome, and neurological function were measured using the ASIA impairment scale, Japanese Orthopaedic Association (JOA) grading scale, and Hirabayashi recovering rate, respectively.

RESULTS

Thirty-three (80.4%) patients showed improvement in ASIA grade at 12-month follow-up. Four (9.7%) patients in ASIA Grade A and 4 (9.7%) patients in ASIA Grade D remain unchanged. The mean JOA score improved from 8.4 ± 6.1 points preoperatively to 11.2 ± 5.4 points at 12 months postoperatively. Improvement in JOA was statistically significant (P < 0.05). The mean Hirabayashi recovery rate was 37.4 ± 25.3%.

CONCLUSION

Surgical decompression (laminoplasty) is helpful in relieving cord compromise and neurological deficit in CSCI with stable spine.

摘要

背景与目的

随着全球老年人口的急剧增加,伴有稳定脊柱的颈脊髓损伤(CSCI)的发生率也在上升。在本研究中,我们评估了这些患者减压手术(椎板成形术)的神经学结果。

材料与方法

对41例行减压手术(椎板成形术)的伴有稳定脊柱的CSCI患者进行回顾性研究。纳入标准如下:无不稳定的CSCI、磁共振成像(MRI)显示脊髓挫伤、脊髓压迫率超过20%、美国脊髓损伤协会(ASIA)神经功能缺损分级为A至D级,以及至少随访12个月。术前神经状态、临床结果和神经功能分别使用ASIA损伤分级量表、日本骨科协会(JOA)分级量表和平林恢复率进行测量。

结果

33例(80.4%)患者在12个月随访时ASIA分级有所改善。4例(9.7%)ASIA A级患者和4例(9.7%)ASIA D级患者无变化。JOA评分术前平均为8.4±6.1分,术后12个月时为11.2±5.4分。JOA评分的改善具有统计学意义(P<0.05)。平林平均恢复率为37.4±25.3%。

结论

手术减压(椎板成形术)有助于缓解伴有稳定脊柱的CSCI患者的脊髓压迫和神经功能缺损。

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