Janković S, Busić Z, Primorac D
Department of Radiology, University Hospital Split, Croatia.
Mil Med. 1998 Dec;163(12):847-9.
The present report summarizes the experience of an evacuation hospital in southern Croatia in treating 96 patients with spine and spinal cord war injuries.
A retrospective review was done for 96 wounded persons (86 soldiers, 10 civilians) with spinal cord injuries from August 1991 through December 1995. The ages ranged from 15 to 59 years (mean, 28.3 years for soldiers, 38.5 years for civilians). Diagnostic procedures were plain radiography, computed tomography, and computed tomographic myelography. However, in most cases a more conservative surgical approach was used.
The highest rates of admittance were recorded in 1992 (N = 38) and 1993 (N = 47). The lumbar spine was injured in 55% of the patients, the cervical and thoracic spines in 17.7%. All injuries were caused by projectiles from automatic rifles and sniper fire (51%) and from fragments of explosive devices (49%). Blast injury of the spinal cord was found in 10 patients. The most frequent complications caused by the fragments were wound infection, urinary tract infection, decubitus, and pneumonia. Four patients (4.2%) died in the hospital, and 43.0% of patients survived but were severely handicapped.
Careful clinical examination combined with modern diagnostic imaging and use of broad-spectrum antibiotics reduced the need for surgical intervention in patients with spinal cord injuries.
本报告总结了克罗地亚南部一家后送医院治疗96例脊柱和脊髓战伤患者的经验。
对1991年8月至1995年12月期间96例脊髓损伤伤员（86名士兵，10名平民）进行回顾性研究。年龄范围为15至59岁（士兵平均年龄28.3岁，平民平均年龄38.5岁）。诊断方法包括X线平片、计算机断层扫描（CT）和CT脊髓造影。然而，在大多数情况下采用了更为保守的手术方法。
1992年（N = 38）和1993年（N = 47）收治率最高。55%的患者腰椎受伤，17.7%的患者颈椎和胸椎受伤。所有损伤均由自动步枪子弹和狙击火力（51%）以及爆炸装置碎片（49%）造成。10例患者发现脊髓爆震伤。碎片引起的最常见并发症为伤口感染、尿路感染、褥疮和肺炎。4例患者（4.2%）在医院死亡，43.0%的患者存活但严重残疾。
仔细的临床检查结合现代诊断成像技术和使用广谱抗生素减少了脊髓损伤患者的手术干预需求。
