Orthopedics. 2022 Nov-Dec;45(6):325-332. doi: 10.3928/01477447-20220907-07. Epub 2022 Sep 13.
This study was undertaken to evaluate the effectiveness of surgical treatment of acute traumatic central cord syndrome (ATCCS) without fracture and dislocation and explore surgical timing and factors influencing postoperative recovery of spinal cord function. We retrospectively collected the general and clinical data of 112 patients with ATCCS (American Spinal Injury Association impairment scale grade C or D) without fracture and dislocation who underwent surgical treatment in our hospital from January 2013 to August 2019. We used statistical methods to evaluate the safety of the operation and explore the timing of surgery and the factors influencing postoperative recovery of spinal cord function. The mean age of the 112 patients was 60.64±12.91 years. The Japanese Orthopaedic Association score and the American Spinal Injury Association motor score (AMS) of the 112 patients were significantly higher at final follow-up than at admission. No significant difference in recovery of spinal cord function was seen between the early operation group (≤4 days) and the late operation group (>4 days). Comparison of patients with a good prognosis vs a poor prognosis showed that age, intrahand muscle strength at admission, maximum spinal cord compression, maximum canal compromise, length of high-intensity signal in the spinal cord on sagittal T2-weighted magnetic resonance imaging, AMS, and American Spinal Injury Association injury grade D/C at admission had a significant effect on recovery of spinal cord function. Surgical treatment of ATCCS without fracture and dislocation is safe and effective. Age, admission AMS and American Spinal Injury Association impairment scale score, intrinsic hand muscle strength, maximum canal compromise, maximum spinal cord compression, and length of high-intensity signal in the spinal cord can be used to predict postoperative recovery of spinal cord function. [. 2022;45(6):325-332.].
本研究旨在评估无骨折脱位的急性创伤性中央脊髓综合征(ATCCS)的手术治疗效果,并探讨手术时机和影响脊髓功能术后恢复的因素。我们回顾性收集了 2013 年 1 月至 2019 年 8 月在我院接受手术治疗的无骨折脱位的 112 例 ATCCS(美国脊髓损伤协会损伤分级 C 或 D)患者的一般资料和临床资料。我们使用统计方法评估手术的安全性,并探讨手术时机和影响脊髓功能术后恢复的因素。112 例患者的平均年龄为 60.64±12.91 岁。112 例患者的日本矫形协会评分和美国脊髓损伤协会运动评分(AMS)在最终随访时均明显高于入院时。早期手术组(≤4 天)与晚期手术组(>4 天)脊髓功能恢复无显著差异。预后良好组与预后不良组比较显示,年龄、入院时手内肌肌力、脊髓最大压迫、椎管最大狭窄、矢状位 T2 加权磁共振成像上脊髓高信号长度、AMS 和入院时美国脊髓损伤协会损伤分级 D/C 对脊髓功能恢复有显著影响。无骨折脱位的 ATCCS 手术治疗安全有效。年龄、入院时 AMS 和美国脊髓损伤协会损伤分级评分、固有手肌力、椎管最大狭窄、脊髓最大压迫和脊髓高信号长度可用于预测术后脊髓功能恢复。[ Spinal Cord. 2022;45(6):325-332.].