Anterior Decompression and Fusion for Old Traumatic Cervical Cord Lesion

以前位減壓及骨融合術治療陳舊頸椎神經傷害

張國華(Kuo-Hwa Zhang)

《Journal of Orthopaedic Surgery Taiwan》 7卷1期 (1990/03) Pp. 53-62

摘要

11位因下頸椎骨折所導致的非完全性脊髓神經損傷，以晚期前位減壓術及骨融合術治療，所有的病人在手術前，均在放射線學上證實有骨或椎間盤由前方壓迫到脊髓神經，在手術後均以電腦斷層掃描證實成功的移除這些壓迫物，所有的病人平均追蹤3.2年。
　　沒有病人手術後損失神經功能，其中九個病人至少進一步一級神經功能，其中六個病人可以再度獨立的行走。
　　這個結果顯示晚期前位減壓術及骨融合手術對於因頸椎骨折而導致的脊髓神經前方壓迫而造成的非完全性頸椎神經損傷，可提供後好的神經功能，更進一步恢復的機會。

並列摘要

11 consecutive patients with incomplete spinal cord injuries secondary to old fractures of the lower cervical spine were treated by anterior decompression and fusion. All patients had radiographically demonstrated anterior compression of spinal cord by bone or disk fragments. Computed tomography was performed after surgery and confirmed the successful removal of the cause of compression in all of them. All patients have been followd for an average 3.2 years.
No patient lost further cord function after the anterior decompression. Nine of the eleven patients improved at least one grade in neurologic function. Six of the eleven patients regained full independent walking ability.
From this study, I conclude that late anterior decompression and fusion is indicatet in incomplete cervical cord lesion secondary to fractures of the lower cervical spine with persistent anterior compression, and offers a very good chance of further recovery of neurological function.

並列關鍵字

incomplete spinal cord injury ； decompression