单开门椎管扩大成形术治疗无骨折脱位型颈脊髓损伤29例临床研究.doc

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1、单开门椎管扩大成形术治疗无骨折脱位型颈脊髓损伤29例临床研究［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

2、，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)-039-02Clinicalanalysisofexpansivelaminoplastyinthetreatmentofcervicalspinalcordinjurieswithout

3、vertebraefracturesanddislocationsQINYunze,WEIMoukuan,LEIJianfei,LIUShaoyan,LIAOXingquanDepartmentofOrthopedicSurgery,thePeoplezsHospitalofRonganCountyinGuangxiZhuangAutonomousRegion,Rongan545400,China[Abstract]Objective：Toexploreandevaluationtheclinicaleffectsof

4、cervicalspinalcordinjurieswithoutvertebraefracturesanddislocationsbyexpansivelaminoplasty.Methods：Reviewedthe29caseswithcervicalspinalcordinjurieswithoutvertebraefracturesanddislocationsinourhospitalfromMarch2006toDecember2010.ResuIts：The29caseswerefollowedupfor

5、anaverageoftwelvemonths(from6to24months)・Noinstabilityofthecervicalspineorreclosedopen-doorwasfoundafterexpansivedecompression.Thespinalcordfunctionwereimprovedtosomeextentin26cases,but2casesofdegreeAanddegreeBhadnoevaluated,therestofthe26casesofspinalcordfuncti

6、onweredifferentofimprovement,neuralkineticenergyclassificationbyFrankelgrades,returntoaElevelin15cases,Dlevel8cases,Clevel3cases・Conclusion：Cervicalspinalcordinjurieswithoutvertebraefracturesanddislocationsareoftenaccompaniedbycervicalspinalcanalstenosisandinter

7、vertebraldischerniationatmultiplesegments.Theexpansivelaminoplastyofcervicalspinehassuchadvantagesascompletedecompression,lesstraumaandlightadversereactions・Itisakindofgoodmethodforthetreatmentofcervicalspinalcordinjurieswithoutvertebraefracturesanddislocations・

8、[Keywords]Cervicalspinalcordinjuries；Withoutvertebraefracturesanddislocation；Expansive1aminoplasty；Clinicalanalysis无骨折脱位型颈脊髓损伤(cervicalspinalcordinjurywithoutfracture