Wu Xinfeng, Song Qingpeng, Jin Peihao, Liu Bo
Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.
Appl Bionics Biomech. 2022 Mar 30;2022:8720290. doi: 10.1155/2022/8720290. eCollection 2022.
To investigate the outcomes of patients with cervical spinal cord injury treated by surgery and their prognostic factors.
We retrospectively analyzed 139 patients with cervical spinal cord injury treated by surgery at our hospital, who were admitted between January 2017 and December 2018. Depending on the Barthel index at last follow-up, the patients were divided into the recovery group ( = 60, Barthel index > 45) and the nonrecovery group ( = 79, Barthel index ≤ 45). General information of patients in the two groups was compared. The significant factors were further introduced into the logistic regression model. The poor prognostic factors of cervical spinal cord injury treated by surgery were analyzed, and specific nursing measures were taken.
There were significant differences in the duration of injury before admission, duration of injury before surgery, transportation and protection before admission, spinal canal invasion rate, and hormonal therapy within 8 h after injury between the patients achieving good postoperative recovery and those not ( < 0.05). Logistic regression analysis showed that all the factors above were prognostic factors for cervical spinal cord injury treated surgically.
The duration of injury before admission, duration of injury before surgery, transportation and protection before admission, spinal canal invasion rate, and hormonal therapy within 8 h after injury were prognostic factors of patients with cervical spinal cord injury treated by surgery. The following factors should be considered for favorable outcomes: spinal protection during transportation to hospital, timely hormonal shock therapy to delay injury progression, and timely surgery to relieve pain. The spine is composed of cervical, thoracic, lumbar, sacral, and caudal vertebrae.
探讨手术治疗颈脊髓损伤患者的疗效及其预后因素。
回顾性分析2017年1月至2018年12月在我院接受手术治疗的139例颈脊髓损伤患者。根据末次随访时的Barthel指数，将患者分为恢复组（n = 60，Barthel指数>45）和未恢复组（n = 79，Barthel指数≤45）。比较两组患者的一般资料。将有统计学意义的因素进一步纳入Logistic回归模型。分析手术治疗颈脊髓损伤的不良预后因素，并采取针对性护理措施。
术后恢复良好与未恢复的患者在入院前损伤时间、手术前损伤时间、入院前转运及保护情况、椎管侵占率、伤后8 h内激素治疗等方面比较，差异有统计学意义（P<0.05）。Logistic回归分析显示，上述因素均为手术治疗颈脊髓损伤的预后因素。
入院前损伤时间、手术前损伤时间、入院前转运及保护情况、椎管侵占率、伤后8 h内激素治疗是手术治疗颈脊髓损伤患者的预后因素。为取得良好疗效，应考虑以下因素：转运至医院途中的脊柱保护、及时给予激素冲击治疗以延缓损伤进展、及时手术以缓解疼痛。脊柱由颈椎、胸椎、腰椎、骶椎和尾椎组成。
