中心性頚髄損傷に対する外科治療の長期成績

概要

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We evaluated long-term surgical results for patients with traumatic cervical central cord syndrome and discussed about prognostic factors. Forty-five patients with traumatic cervical central cord syndrome operated on from October 1986 to November 2002 in our hospital are studied. Neurological symptoms of each patient were estimated by JOA (Japan Orthopedic Association) scoring system. Age, gender, types of injury, causes of trauma, responsible diseases, types of neurological symptom, MRI findings, JOA scores immediate after the trauma, timing of surgery, surgical methods were regulated as predictive factors related to the prognosis. Average rate of neurological improvement was 45.0% and functional improvement of lower extremities (49.6%) was better than that of upper extremities (38.6%). High age (over sixty), responsible disease (occified posterior longitudinal ligament), types of neurological symptoms (upper and lower extremities type), JOA score immediate after the trauma (less than 5 points) were related to poor prognosis. Neurological aggravation related surgery was encountered in only one case (2.2%). Re-operation was needed in two cases (4.4%) due to kyphosis after cervical laminoplasty and local malalignment after cervical anterior fusion. Surgical decompression for patients with traumatic central cervical cord syndrome was safe and long-term results were acceptable.
2004-03-01