单开门椎管扩大成形术治疗无骨折脱位型颈脊髓损伤29例临床剖析.docVIP

单开门椎管扩大成形术治疗无骨折脱位型颈脊髓损伤29例临床剖析 　　[摘要] 目的：探讨单开门椎管扩大成形术治疗无骨折脱位型颈脊髓损伤的临床效果。方法：回顾性分析2006年3月～2010年12月间本科收治的29例无骨折脱位型颈脊髓损伤（CSCIWFD）患者的临床资料。结果：本组29例患者术后平均随访时间为12个月（6～24个月），受压脊髓均获大范围减压未发生颈椎不稳、再次“关门”等现象；经手术后，除术前2例A级和1例B级患者无改善外，其余26例脊髓功能均有不同程度改善，神经功能按Frankel分级标准，恢复至E级15例，D级8例，C级3例。结论：无骨折脱位型颈脊髓损伤多伴有单个或多个节段椎间盘突出以及颈椎管狭窄，单开门椎管扩大成形术减压彻底、创伤较小、不良反应轻，是无骨折脱位型颈脊髓损伤的优良治疗方法 　　[关键词] 颈脊髓损伤；无骨折脱位；单开门椎管扩大成形术；临床分析 　　[中图分类号] R652.1 [文献标识码] A [文章编号] 1674-4721（2012）01（b）-039-02 　　 　　Clinical analysis of expansive laminoplasty in the treatment of cervical spinal cord injuries without vertebrae fractures and dislocations 　　QIN Yunze, WEI Moukuan, LEI Jianfei, LIU Shaoyan, LIAO Xingquan 　　Department of Orthopedic Surgery, the People′s Hospital of Rongan County in Guangxi Zhuang Autonomous Region, Rongan 545400, China 　　[Abstract] Objective: To explore and evaluation the clinical effects of cervical spinal cord injuries without vertebrae fractures and dislocations by expansive laminoplasty. Methods: Reviewed the 29 cases with cervical spinal cord injuries without vertebrae fractures and dislocations in our hospital from March 2006 to December 2010. Results: The 29 cases were followed up for an average of twelve months (from 6 to 24 months). No instability of the cervical spine or reclosed open-door was found after expansive decompression. The spinal cord function were improved to some extent in 26 cases, but 2 cases of degree A and degree B had no evaluated, the rest of the 26 cases of spinal cord function were different of improvement, neural kinetic energy classification by Frankel grades, return to a E level in 15 cases, D level 8 cases, C level 3 cases. Conclusion: Cervical spinal cord injuries without vertebrae fractures and dislocations are often accompanied by cervical spinal canal stenosis and intervertebral disc herniation at multiple segments. The expansive laminoplasty of cervical spine has such advantages as complete decompression, less trauma and light adverse reactions. It is