[1]刘明刚,陈乾,赖碧芬,等.儿童无骨折脱位型脊髓损伤的诊断和治疗[J].临床神经外科杂志,2019,16(6):513-517.[doi:10.3969/j.issn.1672-7770.2019.06.011]
 LIU Ming-gang,CHEN Qian,LAI Bi-fen,et al.Diagnosis and treatment of spinal cord injury without fracture and dislocation in children[J].Journal of Clinical Neurosurgery,2019,16(6):513-517.[doi:10.3969/j.issn.1672-7770.2019.06.011]
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儿童无骨折脱位型脊髓损伤的诊断和治疗()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第6期
页码:
513-517
栏目:
论著
出版日期:
2019-12-10

文章信息/Info

Title:
Diagnosis and treatment of spinal cord injury without fracture and dislocation in children
作者:
刘明刚陈乾赖碧芬谭泽世周洋洋
518000 深圳,深圳市儿童医院神经外科(刘明刚,陈乾,赖碧芬,谭泽世),放射科(周洋洋)
Author(s):
LIU Ming-gang CHEN Qian LAI Bi-fen et al.
Department of Neurosurgery, Shenzhen Children’s Hospital, Shenzhen 518000, China
关键词:
儿童无骨折脱位型脊髓损伤弥散张量成像
Keywords:
children without radiological abnormality spinal cord injury diffusion tensor imaging
分类号:
R651.2
DOI:
10.3969/j.issn.1672-7770.2019.06.011
文献标志码:
A
摘要:
【摘要】目的 探讨儿童无骨折脱位型脊髓损伤的病因、诊断和治疗;提高对儿童无骨折脱位型脊髓损伤的认识。方法回顾性分析深圳市儿童医院2013年6月—2017年12月收治的12例无骨折脱位型脊髓损伤患儿的临床资料。分析患儿受伤原因、出现症状时间,并在入院后24 h内行脊髓MRI检查。脊髓损伤程度根据美国ASIA分级评定。结果本组患儿中,男2例,女10例,年龄3~12岁,平均年龄6岁;致病原因包括颈部扭伤2例、臀部着地4例、腰部轻微外伤2例、舞蹈后下腰动作不当4例。受伤到出现症状时间在30 min~48 h,受伤后到入院时间在3 h~5 d。2例颈部扭伤患儿中,1例患儿颈髓MRI检查未见明显异常,1例患儿颈胸髓MRI可见C1-T12内长T1长T2异常信号影。另外10例患儿中,5例患儿MRI检查未见明显异常,5例患儿T4-L5之间可见不同程度的长T1长T2异常信号影。根据ASIA损害程度分级:A级2例,B级2例,C级6例,D级2例。患儿出院后随访6个月~5年,其中A级1例、D级6例、E级4例,拒绝随访者1例。结论无骨折脱位型脊髓损伤好发于8岁以下儿童,一般有明确的外伤史,MRI检查可以提高无骨折脱位型脊髓损伤的诊断,但常规MRI检查有一定的阴性率。与常规MRI相比,MR弥散张量成像(diffusion tensor imaging, DTI)对脊髓损伤的诊断更为敏感,为研究评判脊髓损伤严重程度及后期运动功能恢复提供了一种非侵入性检查方法;可为无骨折脱位型脊髓损伤的诊断提供依据。
Abstract:
Abstract: ObjectiveTo explore the etiology, diagnosis and treatment of spinal cord injury in children without fracture and dislocation, for further understanding. MethodsThe data of 12 children with spinal cord injury without fracture and dislocation in Shenzhen Children’s Hospital from June 2013 to December 2017 were analyzed retrospectively, including 2 boys and 10 girls, aged 3-12 years, mean age 6 years. The cause of the injury and the time of symptom onset were analyzed, and a spinal cord MR examination was performed within 24 hours after admission. The degree of spinal cord injury was grouped according to the US ASIA classification. ResultsThe pathogenic factors in the children included 2 cases of cervical sprain, 4 cases of buttocks, 2 cases of slight trauma of the lower back, and 4 cases of improper lower back movement after dancing. After the injury, the symptoms ranged from 30 min to 48 h, and the time from the injury to the admission period ranged from 3 hours to 5 days. 2 cases of cervical sprain, 1 case of cervical spinal MR examination showed no obvious abnormality, 1 case of cervical thoracic MR showed C1-T12 long T1 long T2 abnormal signal. Another 10 cases, 5 cases of MR examination did not see obvious abnormalities, and the other 5 cases of T4-L5 could see different degrees of long T1 long T2 abnormal signal. According to ASIA damage degree classification: 2 cases of rade A, 2 cases of grade B, 6 cases of grade C, 2 cases of grade D. After discharge from hospital for 6 months to 5 years, 1 case was refused, 1 case was grade A, 6 cases were grade D, and 4 cases were grade E. ConclusionSpinal cord injury without fracture and dislocation is common in children under 8 years old. There is a clear history of trauma. MR examination can improve the diagnosis of spinal cord injury without fracture and dislocation, but the conventional MR examination has a certain negative rate. Compared with conventional MRI, DTI is more sensitive to the diagnosis of spinal cord injury, and will provide a non-invasive examination method for evaluating the severity of spinal cord injury and recovery of motor function in the future. Provide a basis for the diagnosis of spinal cord injury without fracture and dislocation.

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更新日期/Last Update: 2019-12-10