Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
J Healthc Eng. 2021 Aug 31;2021:4798927. doi: 10.1155/2021/4798927. eCollection 2021.
It is difficult to assess and monitor the spinal cord injury (SCI) because of its pathophysiology after injury, with different degrees of prognosis and various treatment methods, including laminectomy, durotomy, and myelotomy. Medical communication services with different factors such as time of surgical intervention, procedure choice, spinal cord perfusion pressure (SCPP), and intraspinal pressure (ISP) contribute a significant role in improving neurological outcomes. This review aims to show the benefits of communication services and factors such as ISP, SCPP, and surgical intervention time in order to achieve positive long-term outcomes after an appropriate treatment method in SCI patients. The SCPP was found between 90 and 100 mmHg for the best outcome, MAP was found between 110 and 130 mmHg, and mean ISP is ≤20 mmHg after injury. Laminectomy alone cannot reduce the pressure between the dura and swollen cord. Durotomy and duroplasty considered as treatment choices after severe traumatic spinal cord injury (TSCI).
由于脊髓损伤 (SCI) 后的病理生理学原因，评估和监测较为困难，其预后程度不同，治疗方法也多种多样，包括椎板切除术、硬脊膜切开术和脊髓切开术。具有不同因素的医疗沟通服务，如手术干预时间、手术选择、脊髓灌注压 (SCPP) 和脊髓内压 (ISP)，对改善神经功能结局具有重要作用。本综述旨在展示沟通服务以及 ISP、SCPP 和手术干预时间等因素的益处，以实现 SCI 患者在适当治疗方法后的积极长期结局。研究发现，SCPP 最佳值在 90 至 100mmHg 之间，MAP 在 110 至 130mmHg 之间，损伤后平均 ISP 应≤20mmHg。单纯椎板切除术不能降低硬脊膜与肿胀脊髓之间的压力。硬脊膜切开术和硬脊膜修补术被认为是严重创伤性脊髓损伤 (TSCI) 的治疗选择。
