Diagnosis and treatment of hematoma-induced spinal cord injury after operation for fluorosis cervical canal stenosis
10.3760/cma.j.issn.1001-8050.2013.07.009
- VernacularTitle:氟骨病颈椎管狭窄症术后血肿致脊髓损伤的诊治对策
- Author:
Yingpeng XIA
;
Qingfeng SHEN
;
Tiantong XU
;
Huinan LI
- Publication Type:Journal Article
- Keywords:
Spinal cord injuries;
Fluorosis;
Cervical stenosis
- From:
Chinese Journal of Trauma
2013;29(7):614-618
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the causes of hematoma-induced spinal cord injury after surgical treatment of fluorosis cervical canal stenosis (FCCS) so as to conclude the methods for early diagnosis and treatment.Methods A retrospective review was conducted on 329 cases of FCCS undergone expansive laminoplasty (ELOP) between 2006 and 2009.Eighteen out of the 329 cases presented with neural deterioration in postoperative 2 weeks,including l 1 males and 7 females at age of 45-73 years (mean 56.9 years).MRI scan at postoperative 1-5 days confirmed that the injury cause was hematoma formation (incidence of 5.47％).Once the definite diagnosis was made,immediate local puncture decompression,immobilization in the prone position as well as a timely second surgical probe and spinal decompression were performed.Results Nerve symptom of the 18 cases obtained different degree of recovery.Japanese Orthopedic Association (JOA) score promoted from preoperative (7.44 ± 1.25) points to (12.6 ± 2.1)points at 12 months after second operation.Scatter plot between time of definite diagnosis and improvement value in JOA score before and after the second operation was drawn so as to establish linear equation (Y =6.240 7-0.777 8X(F =9.89,P ＜0.01).As a result,the two variables presented a negative linear relationship,which suggested a better outcome after early treatment than delayed treatment.Conclusions Hematoma compression is the main cause of spinal cord injury following operation for FCCS patients.Strict hematosis and alternate lateral clinostatism after operation were effective prevention methods.Besides,early diagnosis and timely treatment are critically important.
