Donovan W H
Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center-Houston.
Paraplegia. 1994 Jun;32(6):375-88. doi: 10.1038/sc.1994.64.
Technological developments over the last two centuries have advanced the spinal surgeon's capability to service the needs of the spinal cord injured person. While the role that surgery can play in shortening hospitalization for tetraplegics has yet to be proven, it does play a much needed role in the correction of instability and prevention of deformity when the possibility of these conditions exist. Surgical intervention for purposes of neural decompression has yet to be proven as justifiable in view of the risks involved. All surgical procedures must be undertaken only after due consideration of the patients' general medical condition, including coexisting trauma, the potential for and actual instability and deformity of the spine, and the neurological level and degree of incompleteness of the patient. In general, the greater the remaining neurological function, the more there is to be gained by early mobilization. Yet, in the face of progressive improvement in neurological function, caution is advised since there will be much to lose if anything goes wrong with the operation.
在过去两个世纪中，技术的发展提升了脊柱外科医生满足脊髓损伤患者需求的能力。虽然手术在缩短四肢瘫痪患者住院时间方面所起的作用尚未得到证实，但当存在不稳定和畸形的可能性时，手术在矫正不稳定和预防畸形方面确实发挥着不可或缺的作用。鉴于神经减压手术存在风险，其合理性尚未得到证实。所有外科手术都必须在充分考虑患者的一般医疗状况后进行，包括并存的创伤、脊柱潜在的和实际的不稳定及畸形情况，以及患者的神经损伤平面和不完全性程度。一般来说，剩余神经功能越强，早期活动所获得的益处就越大。然而，面对神经功能的逐步改善，建议谨慎行事，因为如果手术出现任何问题，将会有很大损失。
