关键词: 脊髓损伤, 颈椎, 解剖机制, 治疗

Abstract:

Objective　To investigate anatomic mechanism and therapeutic choice for the dislocated cervical cord injury without fracture.　Methods　A retrospective case-control study in our hospital from 2000 to 2009 with 43 cases of the dislocated cervical cord injury without fracture was performed. 43 patients were divided into group A (15 cases), treated with drugs and physical method, and group B (28 cases), treated with surgical operation. Group A was further divided into A1(6 cases)， with no compression of cervical spine and the normal spinal sagittal diameter; A2 (9 cases), with the compression of cervical canal, and the sagittal diameter <15 mm. Group B was further divided into B1 (7 cases), with no compression of the cervical spine, and the spinal sagittal diameter ≥ 15 mm; B2 (21 cases), with the compression of cervical canal, and the sagittal diameter less than the normal range. The JOA score were compared between A1 and B1, B1 and B2, A2 and B2 before and after the treatment respectively.　Results　For all patients, both sensory and motor functions improved significantly after the treatment (P<0.05). The therapy effects of group B was better than that of group A (P <0.05). However, there were no difference of JOA scores appeared between A1 and B1, B1 and B2 (P> 0.05). Group B2 was better than the effects of A2 (P<0.05), and A1 was better than that of A2 (P< 0.05). Conclusions　For treatment of the dislocated cervical cord injury without fracture, the individual therapeutic choice should be considered according to the injury mechanism and the results of imaging examination.

Key words: Spinal cord injury, Cervical vertebra, Anatomy mechanism, Therapy