Academic Neurosurgery Unit, St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK.
Department of Neurosurgery, Atkinson Morley Wing, St. George's Hospital NHS Foundation Trust, Blackshaw Road, London SW17 0QT, UK.
Neurosurg Clin N Am. 2021 Jul;32(3):365-376. doi: 10.1016/j.nec.2021.03.008. Epub 2021 May 7.
We discuss 2 evolving management options for acute spinal cord injury that hold promise to further improve outcome: pressure monitoring from the injured cord and expansion duraplasty. Probes surgically implanted at the injury site can transduce intraspinal pressure, spinal cord perfusion pressure, and cord metabolism. Intraspinal pressure is not adequately reduced by bony decompression alone because the swollen, injured cord is compressed against the dura. Expansion duraplasty may be necessary to effectively decompress the injured cord. A randomized controlled trial called DISCUS is investigating expansion duraplasty as a novel treatment for acute, severe traumatic cervical spinal cord injury.
脊髓内压监测和扩张硬脑膜成形术。这两种方法都有改善预后的潜力。在损伤部位植入的探头可以转换脊髓内压、脊髓灌注压和脊髓代谢。单纯的骨减压并不能充分降低脊髓内压，因为肿胀的损伤脊髓会压迫硬脑膜。为了有效地减压损伤脊髓，可能需要进行扩张硬脑膜成形术。一项名为 DISCUS 的随机对照试验正在研究扩张硬脑膜成形术作为急性、严重创伤性颈脊髓损伤的一种新的治疗方法。
