Katoh S, el Masry W S
Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, England.
J Bone Joint Surg Br. 1994 Mar;76(2):225-8.
We reviewed a series of 53 patients with closed traumatic complete injuries of the cervical spinal cord. They were admitted within two days to a spinal injuries centre, treated conservatively by six weeks of bedrest and skull traction, then mobilised in a neck support for six weeks. Eight patients had temporary neurological deterioration, four spontaneously and four after cervical manipulation; seven of these recovered to the initial neurological level without surgery. Of 40 patients followed for more than 12 months, 19 recovered useful motor power in local muscles which were initially paralysed (zonal recovery); one patient showed distal motor recovery. Zonal recovery did not correlate with the mechanism of skeletal injury or with the degree of residual canal stenosis. Sensory sparing and an initial neurological level higher than the level of skeletal injury were both good prognostic signs for zonal recovery.
我们回顾了一系列53例闭合性创伤性颈脊髓完全损伤患者。他们在两天内被收治到一家脊髓损伤中心，接受为期六周的卧床休息和颅骨牵引保守治疗，然后佩戴颈部支撑装置活动六周。8例患者出现暂时性神经功能恶化，4例为自发性，4例在颈椎手法治疗后出现；其中7例未经手术即恢复至初始神经功能水平。在随访超过12个月的40例患者中，19例在最初瘫痪的局部肌肉恢复了有用的运动能力（分区恢复）；1例患者出现远端运动恢复。分区恢复与骨骼损伤机制或残余椎管狭窄程度无关。感觉保留以及初始神经功能水平高于骨骼损伤水平均是分区恢复的良好预后征象。
