Koyanagi I, Iwasaki Y, Isu T, Akino M, Abe H
Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan.
Paraplegia. 1989 Jun;27(3):190-7. doi: 10.1038/sc.1989.28.
Seven cases of acute cervical cord injury examined by CT-myelography are reported. Cord swelling was observed in 2 patients who developed complete lesions. Another 5 cases had an incomplete lesions. Spinal cord swelling indicated severe cord damage. External decompression seemed to have little effect on cord swelling. When cord swelling is absent, neurological improvement was expected though the initial neurological state showed severe deficits. A further 4 patients who had an acute cervical cord injury who were treated by myelotomy at the injury site are also reported. Two patients obtained significant improvement in upper limb function. The presence or absence of cord swelling as shown by CT-myelography is important for diagnosing the severity of cord damage. Myelotomy in the immediate post-accident period may relieve the effects of cord swelling.
报告了7例经CT脊髓造影检查的急性颈髓损伤病例。2例出现完全性损伤的患者观察到脊髓肿胀。另外5例为不完全性损伤。脊髓肿胀表明脊髓损伤严重。外部减压似乎对脊髓肿胀影响不大。当不存在脊髓肿胀时，尽管初始神经状态显示严重缺损，但仍有望出现神经功能改善。还报告了另外4例在损伤部位行脊髓切开术治疗的急性颈髓损伤患者。2例患者上肢功能有显著改善。CT脊髓造影显示的脊髓肿胀与否对于诊断脊髓损伤的严重程度很重要。事故发生后立即进行脊髓切开术可能会减轻脊髓肿胀的影响。
