骨傷を認めない頚髄損傷患者に対する頚椎椎弓形成術の治療成績

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We analyzed the surgical outcome of cervical laminoplasty for patients with acute cervical spinal cord injury without fracture or dislocation and reported the effectiveness of surgical decompression compared with that of conservative treatment. Thirty patients were treated with cervical laminoplasty (surgical group) and thirty-nine patients were treated conservatively (conservative group). We estimated their neurological status using NCSS (Neurological Cervical Spine Scale). Total mean follow-up period was 29.9 months. The average rate of improvement of NCSS was 30.5% in the surgical group and 19.7% in the conservative group. In patients with central spinal cord syndrome, the average rate of improvement was 47.3% in the surgical group and 21.8% in the conservative group. The outcome in surgical group patients was significantly better than for the conservative group in central spinal cord syndrome (p=0.0065). In the surgical group, the average rate of improvement was 10.6% in patients classes as 'serious' preoperatively (an NCSS total score of less than 4 points) and 42.0% in all other patients (an NCSS total score was more than 5 points). The outcome of preoperatively 'serious' patients was significantly poor (p=0.0004). Outcome of surgical group was satisfactory and better than that of conservative group. The surgical indication should be decided cautiously, especially in preoperative 'serious' patients (NCSS total score is less than 4 points).
日本脊髄外科学会の論文
2003-03-31

骨傷を認めない頚髄損傷患者に対する頚椎椎弓形成術の治療成績

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