Simpson R K, Venger B H, Narayan R K
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas 77030.
J Trauma. 1989 Jan;29(1):42-6.
A retrospective review of 160 cases of penetrating spinal injury (PSI) was undertaken to assess the benefits and risks of operative treatment. Criteria for operation included incomplete deficits, worsening neurological status, and associated visceral perforation. Of the 160 cases, 142 had gunshot wounds (GSW) and 18 had stab wounds (SW). Laminectomy, with or without intradural exploration, was undertaken in 23% of cases. No significant differences in outcome were found between the surgical and nonsurgical groups. Meningitis, CSF leakage, and wound infections were complications that occurred more often in the surgically treated group (22%) than the conservatively managed group (7%). It has not been possible to demonstrate a benefit of surgery in PSI in this retrospective study. A prospective study is proposed that would allow better control of the variables affecting outcome.
对160例穿透性脊髓损伤（PSI）患者进行了回顾性研究，以评估手术治疗的益处和风险。手术标准包括不完全性神经功能缺损、神经功能状态恶化以及合并内脏穿孔。160例患者中，142例为枪伤（GSW），18例为刺伤（SW）。23%的病例进行了椎板切除术，无论是否进行硬脊膜内探查。手术组和非手术组的预后无显著差异。脑膜炎、脑脊液漏和伤口感染等并发症在手术治疗组（22%）比保守治疗组（7%）更常见。在这项回顾性研究中，尚未证明手术对PSI有益。建议进行一项前瞻性研究，以便更好地控制影响预后的变量。
