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《Journal of Practical Orthopaedics》 2007-01
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The First Aid and Treatment for the Cervical Spinal Cord Injury Caused by Cervical Frac-ture and Dislocation

WANG Yi-sheng,ZHAI Fu-ying,WANG Li-min,et al (Department of Orthopaedic Surgery,The First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China)  
Objective To study the effect of first aid and treatment for the cervical spinal cord injury and dislocation underwent the surgery.Methods The mean of the injury history was 4.5 days with a range of 5 hours~12 weeks.There were 140 cases with cervical fracture,in which 50 cases with lightly compressing fracture and disc hernaiation,119 cases with cervical fracture and dislocation,20 cases only with dislocation,and 16 cases with articular process wringed in this group.The injury level was C4 in 17 cases,C5 in 29,C6 in 39,C7in 35,C4-5 in 38,C5-6 in 58,C6-7 in 49,C4-6 in 16,and C5-7 in 14.According to the classification of Frankel,grade A was in 20 cases,grade B in 91,grade C in 124,and grade D in 60.The first aid include the braking neck,reducing the temperature if high fever,snuff oxygen,and using steroid,dehydration medicine,energy,neurotrophy medicine and so forth.236 patients were treated with anterior enlarged decompression.31 patients with the cord compressed from posterior side were treated by posterior approach surgery.28 patients with the cord compressed from both of anterior and posterior sides were treated by anterior and posterior surgery one time.Results All patients were obtained follow-up for 0.5~18 years with a mean of 11.8 years.The results showed that 178 patients got the restore in the function of the spinal cord and nerve,at least advanced one grade.The total effective rate was 60.3%.The best results were obtained from the cases with the cervical lightly compressive fracture and the disc hernia(88.0%).Conclusion In the first aid and treatment for the spinal cord injury caused by cervical fracture and dislocation.The braking neck,using steroid and dehydration medicine should not be ignored.The better effect may be obtained with early and quite removing the compressive elements to the spinal cord and stabilizing the cervical spine.The complications should be actively prevented and treated.
【CateGory Index】: R683;R651.2
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