Clinical diagnosis analysis in 21 cases of spinal cord disease
21 cases of spinal cord disease were clinically analyzed of which 14 cases were male. 7 female, aged from 30 to 69, weraged 50.9. This group contained 2 cases of consciusness dysfunction. 2l of sensational dysfunction. 19 of morion dysrunction, 11 of aotonomic nerve dysrunction, 2 of, sexual dysfunction. 2 of Brown-Sequrd syndrome. llhad been chrmcally sympromatic for more than two months. the other were of acute for sub acute onset. The segments of the diseases were found mainly at cervical and thoracic ones. to which more attention should be pazd clincally. The incidences of intramedullary lesions were a bit more than that of extramedullary ones. Of the 11 extramendullary cases, 8 arised srorn verteoral body (72.7%), of which 6 cases arisen form the intervertebral dies, or 75%. On which emphasis should be laid clinically Foci in brain and spinal cord were found synchronically in 5 cases (23.8%). They were Wernick cerebral disease, metastetic cerebral tumor, cerebral infarction, polioencephalomyelitis. So possibility of brain disease should also be considerod when diagnosing spinai cord disease, especially in stenosis of cervical canal. Oppressed spinal cord was accodiated with cerebellopontine angle tumor. Disease in brain was negiected because of concermng spinal cord disease and cerehellopontine angie giant meningiona was discovered 5 yeas laaer. There are several methods to diagnose spinal cord disease, including X-rays photography, CSF test, CT, and MRI, etc. X-rays photography should be used for involved vertebral body in lateral and P-A position at first when to suspect spinal cord disease. It should be avoided that neglecting X-rays photography and using CT or MRIfirst. It should be noted when taking segments examination by CT or MRI, thut the actual vertebral body is usually located 7”- 14 segments below the spinal cord involved. Otherwise, misdiagnosis would be resulted. 4 c ases of oppressive spinal cord disease of this group were treated with operating and good result was achieved postoperauvety except i case of paraplegia due be oppressed for too long. Operative indication should be known well. Oppressive disease, for instance, canal sternosis should be treated surgically before function of spinal cord was severely damaged. Good postoperative resulu would be gained for spinal cord oppressed within one year. Total iaminectomy was performed for canal stenosis. Intervertebral foramen decompression should be performed for boundary stenosis and roots to be oppressed. Abnormal gyperplasia of extradura mater of spinal cord fat, ligamentum flavum, arncular process and spur fomaion should be compietely resected. 80-88% satisfactory rate was achieved by laminectomy.
spinal cord、cerebellopontine angle
8
R65
2005-07-07(万方平台首次上网日期,不代表论文的发表时间)
共1页
98