本文選題：下頸椎損傷 + 下頸椎損傷分類評分　； 參考：《中國脊柱脊髓雜志》2016年05期

【摘要】：目的 :探討下頸椎損傷分類(sub-axial injury classification,SLIC)評分在下頸椎損傷術(shù)式選擇中的應(yīng)用價(jià)值。方法:收集我院2009年1月~2013年9月收治的單節(jié)段下頸椎損傷患者126例,其中男86例,女40例,年齡16~72歲(46.4±4.3歲)。高處墜落傷28例,車禍傷62例,跌倒傷21例,高空墜物砸傷15例。損傷部位:C3/4 19例,C4/5 34例,C5/6 52例,C6/7 21例。脊髓損傷程度按照美國脊髓損傷協(xié)會(ASIA)標(biāo)準(zhǔn)分級,A級7例,B級48例,C級54例,D級17例。以前柱或前中柱損傷為主的患者45例,以后柱損傷或中、后柱損傷為主的患者13例,三柱均損傷的患者68例。術(shù)前進(jìn)行SLIC評分,其中4分13例,5分24例,6分23例,7分29例,8分17例,9分13例,10分7例。根據(jù)患者受傷機(jī)制、椎體損傷形態(tài)特點(diǎn)、脊髓受壓部位及損傷程度等因素綜合分析選擇手術(shù)方案,85例患者采用前路手術(shù)治療,其中7例三柱嚴(yán)重?fù)p傷的患者因全身情況不能耐受手術(shù)放棄前后聯(lián)合手術(shù)而選擇單純前路手術(shù);12例行后路手術(shù),其中2例關(guān)節(jié)突絞鎖的患者SLIC評分為8分;29例采用前后聯(lián)合術(shù)式,其中1例為強(qiáng)直性脊柱炎患者。按照損傷程度,將SLIC評分4~5分歸類為輕度損傷,6~7分為中度損傷,8~10分為重度損傷,分析三種術(shù)式患者的SLIC評分情況,總結(jié)規(guī)律。結(jié)果 :前路手術(shù)患者SLIC評分為5.95±1.31分(4~10分),后路手術(shù)患者為6.25±1.29分(4~8分),前后聯(lián)合入路手術(shù)患者為8.76±0.83分(7~10分)。前路手術(shù)組輕、中、重度損傷分別為34、44、7例,4~7分者占92%;后路手術(shù)組輕、中、重度損傷分別為4、6、2例,4~7分者占83%;前后聯(lián)合入路手術(shù)組中度和重度損傷分別為1、28例,8~10分者占97%。結(jié)論:對單節(jié)段下頸椎損傷患者,當(dāng)SLIC評分≥8分時(shí),傾向于選擇前后聯(lián)合術(shù)式;SLIC評分在4~7分時(shí),傾向于選擇單純前路或后路手術(shù)。
[Abstract]:Objective: to evaluate the value of sub-axial injury classification (SLICI) score in the selection of surgical methods for lower cervical spine injury. Methods: from January 2009 to September 2013, 126 patients (86 males and 40 females) with single segment lower cervical spine injury were collected. The age was 1672 years old and 46.4 鹵4.3 years old. There were 28 cases of falling injury, 62 cases of accident injury, 21 cases of falling injury and 15 cases of falling object injury. Injury site: C3 / 4 19 cases C4 / 534 cases C5 / 6 52 cases C6 / 7 21 cases. The degree of spinal cord injury was classified according to the ASIA standard of American Spinal Cord injury Association. There were 7 cases of grade A, 48 cases of grade B, 54 cases of grade C and 17 cases of grade D. There were 45 cases with anterior column or anterior middle column injury, 13 cases with posterior column injury or middle column injury, and 68 cases with three columns injury. Preoperative SLIC score was performed in 13 cases with 4 points, 24 cases with 5 points, 23 cases with 6 points, 29 cases with 7 points, 17 cases with 8 points, 13 cases with 9 points and 7 cases with 10 points. According to the injury mechanism of the patients, the morphological characteristics of the vertebral body injury, the compression position of the spinal cord and the degree of injury, 85 cases of surgical treatment were selected. Among them, 7 patients with severe injury of three columns, because of the whole body condition can not tolerate the combined operation before and after giving up surgery, choose the simple anterior approach surgery and 12 cases of posterior approach surgery. The SLIC score of 2 cases with articular strangulation was 8 points and 29 cases were treated with anterior and posterior combined operation, and one case was ankylosing spondylitis. According to the degree of injury, the SLIC score of 4 ~ 5 was classified as mild injury and 7 were classified as moderate injury and 8 / 10 as severe injury. The SLIC scores of the three types of operation were analyzed and the rules were summarized. Results: the SLIC score of the patients undergoing anterior approach operation was 5.95 鹵1.31 minutes from 4 to 10 minutes, that of the patients with posterior approach was 6.25 鹵1.29 minutes from 4 to 8 minutes, and that of the patients with anterior and posterior combined approach was 8.76 鹵0.83 minutes and 710 minutes respectively. In the anterior operation group, the scores of severe, moderate and severe injuries were 34-44.The scores of 4 ~ 7 were 922 in the anterior operation group, 4 ~ 6 in the posterior operation group, and 83-7 in the moderate, moderate and severe injury respectively in the posterior approach group, while in the combined anterior and posterior approach operation group, the moderate and severe injuries were 88-10 or 97.In the posterior approach group, 88-10 cases were involved in the severe injury, respectively. Conclusion: for patients with single segment lower cervical spine injury, when the SLIC score is 鈮，

本文編號：1882776