骨傷の明らかでない中心性脊髄損傷に対する外科的治療

概要

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We investigated 16 surgically treated cervical central spinal cord injury patients (10 males and 6 females) without bony injury. Age at injury varied from 24 to 84 (mean, 60.3 years). Magnetic resonance (MR) imaging disclosed spinal cord compression in all patients. Dynamic cervical lateral X-ray showed mild to moderate instability in 11 patients. Fourteen patients who had been admitted within 8 hours after the injury were treated with high-dose methylpredonisolone. Interval between injury and surgery ranged from 1 to 35 (mean, 8.6) days. Patients with a single or two-level segmental cord compression underwent anterior decompression and fusion while patients with multi-level cord compression underwent posterior decompression and fusion. Postoperatively, all patients showed neurological improvement of one to two grades on Frankel's scale. Our results demonstrated that the relatively early surgical intervention will be mandatory for the patients with cervical central spinal cord injury with instability and cord compression.
日本脊髄外科学会の論文
2001-03-31