Kang J D, Figgie M P, Bohlman H H
Department of Orthopaedic Surgery, University Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106.
J Bone Joint Surg Am. 1994 Nov;76(11):1617-28. doi: 10.2106/00004623-199411000-00004.
We analyzed three factors involved in fractures and dislocations of the cervical spine and their relation to the degree of injury of the spinal cord. The three factors were the space available for the spinal cord at the level of the injury, the sagittal diameter of the spinal canal at the uninjured levels, and the Pavlov ratio at the uninjured levels. Of the 288 patients analyzed, eighty-three had a complete injury of the spinal cord, ninety-two had an incomplete injury of the spinal cord, thirty had an isolated nerve-root injury, and eighty-three had no neurological deficit. The mean space available for the spinal cord at the level of the injury was 10.5 millimeters for the patients who had a complete injury of the spinal cord, 13.1 millimeters for those who had an incomplete injury of the spinal cord, 15.9 millimeters for those who had an isolated nerve-root injury, and 16.7 millimeters for those who had no neurological deficit. The difference between the groups was significant (p < 0.001) except for the difference between the patients who had an isolated nerve-root injury and those who had no neurological deficit. The mean sagittal diameter of the canal at the uninjured levels was 16.1 millimeters for the patients who had a complete injury of the spinal cord, 16.1 millimeters for those who had an incomplete injury of the spinal cord, 17.9 millimeters for those who had an isolated nerve-root injury, and 18.1 millimeters for those who had no neurological deficit. The difference between the patients who had a complete injury of the spinal cord and those who had an incomplete injury of the spinal cord and that between the patients who had an isolated nerve-root injury and those who had no neurological deficit were not significant (p > 0.05). However, the patients who had a complete injury of the spinal cord and those who had an incomplete injury of the spinal cord were significantly different from the patients who had an isolated nerve-root injury and those who had no neurological deficit (p < 0.001). The mean Pavlov ratio at the uninjured levels was 0.82 for the patients who had a complete injury of the spinal cord, 0.84 for those who had an incomplete injury of the spinal cord, 0.96 for those who had an isolated nerve-root injury, and 0.96 for those who had no neurological deficit.(ABSTRACT TRUNCATED AT 400 WORDS)
我们分析了与颈椎骨折和脱位相关的三个因素及其与脊髓损伤程度的关系。这三个因素分别是损伤水平处脊髓的可用空间、未损伤水平处椎管的矢状径以及未损伤水平处的帕夫洛夫比值。在分析的288例患者中，83例脊髓完全损伤，92例脊髓不完全损伤，30例孤立神经根损伤，83例无神经功能缺损。脊髓完全损伤患者损伤水平处脊髓的平均可用空间为10.5毫米，脊髓不完全损伤患者为13.1毫米，孤立神经根损伤患者为15.9毫米，无神经功能缺损患者为16.7毫米。除孤立神经根损伤患者与无神经功能缺损患者之间的差异外，各组之间的差异具有显著性（p < 0.001）。脊髓完全损伤患者未损伤水平处椎管的平均矢状径为16.1毫米，脊髓不完全损伤患者为16.1毫米，孤立神经根损伤患者为17.9毫米，无神经功能缺损患者为18.1毫米。脊髓完全损伤患者与脊髓不完全损伤患者之间以及孤立神经根损伤患者与无神经功能缺损患者之间的差异无显著性（p > 0.05）。然而，脊髓完全损伤患者和脊髓不完全损伤患者与孤立神经根损伤患者和无神经功能缺损患者有显著差异（p < 0.001）。脊髓完全损伤患者未损伤水平处的平均帕夫洛夫比值为0.82，脊髓不完全损伤患者为0.84，孤立神经根损伤患者为0.96，无神经功能缺损患者为0.96。（摘要截短至400字）
