Without Fracture And Dislocation Of Cervical Spinal Cord Injury The Recent Surgery Efficacy

Objective:To investigate the pathological basis of the cervical spinal cord injury without fracture and dislocation, evaluating the effect of the anterior and posterior surgical treatment method, in order to offer theoretical support to clinical treatment.Methods:There were 62 cases who suffered cervical spinal injury without facture and dislocation during the period from 2008-01 to 2010-06. The retrospective analysis had been done in the followed up 40 cases of the 62 cases. all cases have been operated by 5 Professors.40 cases were followed up,22 cases were followed up in outpatient,18 patients were followed up by telephone, the follow-up rate was 64.5%, there were 6 cases died within 3 months after discharge,16 patients lost to follow up. the follow-up time was 6-30 months, mean 23 Months. (1)the patients were divided into anterior surgery groups, posterior surgery groups.Health status was measured pre- operation and post- operation using validated measurements.These were Frankel criterion,JOA scores,NDI,SF-36 to evaluate spinal cord function.(2) According to the different operation time after injury, the patients were divided into three groups. One was operated within 7 days after injury,another was operated within 7-14 days,the third group was operated after 14 days. Health status was measured pre- operation and post- operation using validated measurements.These were Frankel criterion,JOA scores,NDI,SF-36 to evaluate spinal cord function.Results:in 40 cases of cervical spinal cord injury without fracture and dislocation, over-extend injury 35 cases, develepmental cervical spinal canal stenosis 7 cases, degenerative cervical spinal canal stenosis 13 cases, cervical disc herniation 26 cases, All segments with anterior fixation attained solid fusion without loosening or breakage implants except 2 cases with the titanium mesh subsidence and screws loosening. No re-closed was expanded with spinal cord decompression.Of these measurements, JOA scores,NDI,SF-36,Frankel criterion.There was no significant statistically difference between anterior surgery group and posterior surgery group (p> 0.05). Of these measurements, JOA scores,NDI scores,SF-36 scores,Frankel criterion, There was significant statistically difference among the operated within 7 days groups,the operated within 7-14 days groups and the operated after 14 days groups(P<0.05).Condusions:Cervical disc herniation, cervical spinal stenosis are important pathologic basis of cervical spinal cord injury without fracture and dislocation; If operative method is proper,either anterior or posterior approach can achieve good myeloid functional recovery, early surgery can get a better effect,operation should be doen within 14 days.