《中国康复理论与实践》 ›› 2004, Vol. 10 ›› Issue (12): 765-766.

• 临床研究 • 上一篇    下一篇

儿童新鲜无放射影像异常颈脊髓损伤临床分析

陈立民1; 姚猛1; 张旗涛1; 孙崇毅1; 王正雷2; 高吉昌2   

  1. 1.哈尔滨医科大学第二临床医学院骨科 黑龙江哈尔滨市 150086;2.解放军第211医院骨科 黑龙江哈尔滨市 150080
  • 收稿日期:2004-04-22 出版日期:2004-12-25 发布日期:2004-12-25

Clinical analysis of fresh cervical spinal cord injury without radiographic abnormality in children

CHEN Li-min, YAO Meng,ZHANG Qi-tao, et al   

  1. Department of Orthopaedics, The Second Affiliated Hospital, Harbin Medical University, Harbin 150086,Heilongjiang, China
  • Received:2004-04-22 Published:2004-12-25 Online:2004-12-25

摘要: 目的探讨儿童新鲜无放射影像异常颈脊髓损伤(SCIWORA)的临床特点及治疗。方法对14例儿童SCIWORA(非手术治疗13例、颈后路寰枢椎融合术1例)进行回顾性分析。结果本组患儿死亡1例,13例获平均3年随访,无明显改善者3例,其余患儿肢体功能均有不同程度的恢复。根据ASIA分级标准,治疗前为A级3例、B级5例、C级5例、D级1例;治疗后恢复至B级1例、C级2例、D级5例、E级2例。结论颈椎一过性脱位造成的脊髓损伤是儿童SCIWORA的主要原因,神经功能恢复情况与脊髓原发性损伤程度密切相关,治疗以非手术方法为主,对存在颈椎明显不稳者可采用手术治疗。

关键词: 放射影像, 颈脊髓损伤, 治疗, 儿童

Abstract: ObjectiveTo investigate the clinical characteristics and therapy of fresh cervical spinal cord injury without radiographic abnormality (SCIWORA) in children.MethodsThe materials of fourteen SCIWORA children (13 cases treated with non operative menthod, 1 case treated by atlantoocciptal fusion) were analyzed retrospectively.ResultsOne child was dead, and the other 13 cases had a 3-year follow up. Three children's symptoms had no change. According to ASIA criterion, there were 3 cases with grade A, 5 cases with grade B, 5 cases with grade C and 1 case with grade D before treatment. After treatment, there were 1 case recovered to grade B, 2 cases recovered to grade C, 5 cases recovered to grade D, 2 cases recovered to grade E.ConclusionSpinal cord injury caused by a short time dislocation of cervical vertebrae is the main reason of SCIWORA in children. The degree of the injury of spinal cord is related directly with the recovery of function of nervous system. Most patients can get satisfactory results by non operative methods. Operations are useful to the cases with obvious instability of cervical spine.

Key words: radiographic, cervical spinal cord injury, treatment, children