| Objective:To found out the risk factors causing iatrogenic spinal cord injury,and to provide the theory support for reducing the spinal cord injury during spine operation.Methods:We took retrospective analysis and statistical description on 34 cases(injury group) of spinal cord injury after cervical vertebra or thoracic vertebra operation from Jan 2002 to Jan 2009 in Xiangya hospital of Central south university.And then we got the 86 cases(control group) using the group matched and randomly analysis from the non spinal cord injury cases at the same time.We made the investigation table and comparatively analyzed 30 variations of two groups including clinical factors,iconography factors,operation and pathology factors,and protective factors.Took the one-factor analysis of 30 variations,and then analyzed the obviously different index in statistics using multi-factor unconditioned Logistic analysis.According to these,we found out the main risk factors that the most probably lead to iatrogenic spinal cord injury in cervical vertebra,thoracic vertebra operation.Results:2437 cases of cervical vertebra and thoracic vertebra(C1-T12) operation investigated,the spinal cord injury happened to 34 cases,which 21 cases happened to male and 13 cases happened to female;meanwhile 26 cases are cervical vertebra,and 8 cases are thoracic vertebra.Comparing injury group with control group:One factor comparison between the two groups shows that there is significant difference(P＜0.05) in nine variations which are merge hypertension, merge diabetes mellitus,nerve function grade(ASIA grade),the ratio of spinal canal stenosis,the ratio value of spinal cord area/efficient area of vertebral canal,spinal cord MRIT2WI high signal,the amount of blooding in operation,intraspinal prominence adhesion to dura mate of spinal cord and using methylprednisolone during operation,multi-factor Logistic regression analysis reveals nerve function grade(ASIA grade), the value of spinal cord area/efficient area of vertebral canal,spinal cord MRIT2WI high signal,the amount of blooding in operation and are positive correlation,and there are the independent risk factor of ISCI. Thereby using methylprednisolone during operation is negative correlation,and it is the independent protective factor for ISCI.Conclusions:1.Merger diabetes mellitus,poor nerve function(ASIA grade) before operation,spinal cord/vertebral canal area ratio reduce,preoperative MRIT2 in spinal cord display high signal,amount of bleeding in operation are the risk factors of occurring ISCI during cervical vertebra or thoracic vertebra operation.2.Using large dose methylprednisolone can prevent ISCI occurring. |
