75-颈中央脊髓损伤综合征手术时间点与疗效的相关性研究三院叶一1.doc

颈中央脊髓损伤综合征手术时间点与疗效的相关性研究 叶一 蒋国强程黎明 【摘要】目的: 探讨颈中央脊髓损伤综合征伤后至手术时间与疗效的相关性。方法:回顾性分析2007年3月2011年3月31例颈中央脊髓损伤综合征患者7d内接受手术治疗)，共14例；晚期手术组(伤后7d以后接受手术治疗)，共17例。观测入院时、术后半年及末次随访时日本骨科学会 (Japanese Orthopedics Association，JOA)评分及改善率，采用配对样本t检验对手术前后JOA评分进行比较，采用独立样本t检验对早期和晚期手术组JOA改善率进行比较，采用散点图和Pearson相关系数分析伤后至手术时间与JOA改善率的相关性。结果:12～25个月[（16.10±4.54）个月]随访。患者均获得不同程度的神经功能恢复。早期手术组随访时的JOA改善率优于晚期手术组，差异有统计意义（P＜0.01）。散点图及Pearson相关分析表明，伤后至手术时间与术后随访时的JOA改善率呈负相关（P＜0.01）。结论：颈中央脊髓损伤综合征伤后至手术时间与疗效 【关键词】颈椎脊髓损伤 Surgical management of central cord syndrome: correlation between surgical timing and functional outcome. YE Yi,JIANG Guo-qiang Department of Spinal Surgery,The Affiliated Hospital of Medical College of Ningbo University,Ningbo 315020,China Corresponding author: JIANG Guo-qiang,Email:jgq6424@ 【Abstract】Objective To evaluate the correlation between the surgical and outcome for central cord syndrome.Methods A retrospective analysis was done for the 31 patients who had been operated on between March 2007 and March 2011.According to the timing of surgical intervention,they were divided into early surgery group(14 patients) and late surgery group(17 patients).The neurological status of all patients was recorded on presentation and at follow-up using the JOA scale.A paired-samples t test was performed to compare the preoperative and postoperative JOA scores. The JOA recovery rate between early surgery group and late surgery group was compared using independent-samples t test. A analysis on the correlation between the surgical timing and JOA recovery rate was done using the scattergram and Pearson correlation coefficient.Results The average period of follow-up was（16.10±4.54）months(range 12 to 25 months).All patients had a varying degree of neurological recovery. The JOA recovery rate of early surgery group was apparently better than late surgery group at half a year or the last follow-up after surgery (P＜0.0).The results of the scattergram and Pearson correlation coefficient showed that the JOA recov