原著
中心性頚髄損傷急性期の治療成績
2010 年 24 巻 2 号 p. 178-183
詳細
2010 年 24 巻 2 号 p. 178-183
Objective : Central cord syndrome is the more common incomplete type of spinal cord injury in patients of middle and older age associated with hyper-extention of the cervical spine. We summarized the treatment outcome of patients with central cervical cord injury (CCCI) and evaluated recovery of neurological function.
Methods : Sixty-one patients of CCCI were treated. The clinical characteristics including age, gender, cause and mechanism of trauma, neurological symptoms, treatment were retrospectively obtained from medical records and statistically analyzed as prognostic factors for better outcome. Patients received thirty-one of 61 steroids as the NASCIS-Ⅱ protocol just after admission. Seventeen patients were treated surgically. NCSS (Neurological Cervical Spine Scale) was used for the evaluation of neurological symptoms and singns estimation of the rate of recovery.
Results : Male were 43 cases and female were 18, averaged age was 60.1 years (ranged 25-86 years, median age was 63 years). Improvement was obtained in all cases but complete resolution of neurological deficit was obtained in only 2 of 61. The average rate of recovery in NCSS scoring was 59.1%. Neurological signs and recovery of lower extremities were statistically better than those of upper extremities. Treatment-related death was not experienced. The clinical characteristics of patients were statistically analyzed, males demonstrated better outcome than femals and the group of traffic accident better than that of falling patients group. The averaged rate of recovery was not statistically different between medical and surgical treatment groups, 59.6% and 57.6%. The duration from onset of trauma to the surgical treatment was not influencing for the outcome.
Conclusion : Treatment outcome in patients with CCCI was having acceptable resnlts, but complete resolution of neurological signs was difficult. Neurological symptoms and recovery of upper extremities were worse than that of lower extremities. Surgical treatment for CCCI could improve the outcome even on the conservative treatment group.
