手术治疗创伤性中央脊髓综合征的疗效
Efficacy of surgical treatment in traumatic central cord syndrome.
作者信息
Chen T Y, Lee S T, Lui T N, Wong C W, Yeh Y S, Tzaan W C, Hung S Y
机构信息
Department of Neurosurgery, Chang Gung Medical College, Kweishan, Taoyuan, Taiwan.
出版信息
Surg Neurol. 1997 Nov;48(5):435-40; discussion 441. doi: 10.1016/s0090-3019(97)00037-2.
BACKGROUND
Controversy surrounds the treatment of traumatic central cord syndrome (TCCS), as there are strong advocates for nonsurgical treatment for most patients. However, conservative treatment has been shown to yield a longer period of discomfort from pain and weakness in certain cases.
METHODS
In a retrospective review of 114 patients presenting with acute or chronic TCCS from 1988-94, four different age groups were separately observed under different treatments. Motor and sensory recovery were assessed.
RESULTS
Better results were achieved in younger patients, with or without radiographic abnormalities, and in patients with clinically correlated encroaching cord lesions who received early surgical decompression.
CONCLUSIONS
Surgical intervention for TCCS must be addressed with careful clinical and radiographic survey. Removal of offending lesions in the subacute period results in significant motor and sensory improvement in short-term and long-term follow-up.
背景
创伤性中央脊髓综合征（TCCS）的治疗存在争议，因为大多数患者强烈主张非手术治疗。然而，保守治疗在某些情况下已显示出会导致疼痛和无力带来更长时间的不适。
方法
对1988年至1994年出现急性或慢性TCCS的114例患者进行回顾性研究，在不同治疗方法下分别观察四个不同年龄组。评估运动和感觉恢复情况。
结果
年龄较小的患者，无论有无影像学异常，以及临床相关的脊髓受压病变且接受早期手术减压的患者，取得了更好的效果。
结论
TCCS的手术干预必须通过仔细的临床和影像学检查来确定。在亚急性期去除致病病变可在短期和长期随访中带来显著的运动和感觉改善。
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