中老年人颈髓损伤中央综合征的临床特点及治疗
脊髓损伤,,脊髓损伤；中央综合征；外科治疗；预后,临床资料,1病例筛选,2一般资料,3病例分组,4神经功能损伤程度,5治疗方法,结果,1一般情况,2影
摘要：目的 分析中老年患者颈髓损伤中央综合征的临床特点，探讨治疗方法及预后的影响因素。方法 检索并回顾性分析1999年1月～2004年12月期间我科收治、随访3个月以上、年龄在50岁以上的19例颈髓损伤中央综合征临床资料，对其受伤机制、神经功能损伤程度、影像学表现、治疗方法、疗效进行分析。结果 根据患者损伤暴力程度和原有颈椎退变程度分为4组：A组(n=8)：暴力大、退变重；B组(n=4)：暴力大、退变轻；C组(n=5)：暴力小、退变重；D组(n=2)：暴力小、退变轻。神经功能损伤程度依次为A、C、B、D。A、B、C组均接受前路减压植骨融合手术治疗，D组接受保守治疗。预后良好程度依次D、B、C、A。结论 中老年人颈髓损伤中央综合征的神经损害程度与受伤暴力及原有颈椎退变程度成正相关，预后与之呈负相关，前路减压是治疗该损伤的有效术式。关键词：脊髓损伤；中央综合征；外科治疗；预后
Clinical characteristics and treatment of central cord syndrome of cervical spine in old patients
LI Yuanan,ZHAO Jianhua,LIU Peng,et al.
(Department of Orthopaedics,Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing 400042，China)
Abstract：Objective To analyze the clinical characteristics,appropriate methods of treatment and related factors of prognosis of central cord syndrome of cervical spine in old patients.Methods A retrospective study was designed.Data of patients met the demands below were collected: 50 years old and above, admission between Jan,1999 and Dec,2004,meeting the diagnosis of central cord syndrome of cervical spine,followup at least 3 months.Mechnism of injury,neurological function impairment,characteristics of imaging,treatment and therapeutic effect were analyzed.Results According to the violence of trauma and preexsiting cervical degeneration,ninteen patients were divided into four groups.Group A had severe preexsiting degeneration and was injuried by strong violence;Group B:mild degeration and strong violence;Group C:severe degeneration and weak violence;Group D:mild degeration and weak violence.Group A,B,C underwent anterior decompression and Group D expectant treatment.Neurological function impairment was found to be most severe in Group A and became less severe successively in Groups C ......
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