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硬膜切开术与骨髓切开术在脊髓损伤修复中的作用
Effects of durotomy versus myelotomy in the repair of spinal cord injury
当前的脊髓损伤管理旨在减少继发性损伤并恢复感觉和运动。急性脊髓损伤常伴有脊髓腔室综合征。通过硬膜切开术和/或骨髓切开术减压试图通过完全减轻脊髓的压迫，去除坏死组织，减少水肿，减少出血和改善脊髓的血液循环来减轻继发性损伤。然而，脊髓损伤后的硬膜切开术和/或骨髓切开术是否有益于神经恢复尚存争议。这篇综述比较了硬膜切开术和骨髓切开术在治疗脊髓损伤中的临床效果。我们发现，在临床上硬膜外切开术比骨髓切开术执行得更多，并且硬脊膜切开术可能比骨髓切开术更安全，更有效。在本评价中，在人中进行硬膜切开术对神经功能有积极作用，占92.3％，而在动物中进行硬膜切开术，对神经功能有积极作用，占83.3％。骨髓切开术程序在80％的动物研究中均有效，但只有一项骨髓切开术的临床研究报告了对人体运动和感觉改善的积极结果。但是，许多新的动物研究报告说，硬膜切开术和骨髓切开术对脊髓损伤无效。需要更多的临床数据，以随机对照研究的形式，以了解硬膜切开术和骨髓切开术的有效性。骨髓切开术程序在80％的动物研究中均有效，但只有一项骨髓切开术的临床研究报告了对人体运动和感觉改善的积极结果。但是，许多新的动物研究报告说，硬膜切开术和骨髓切开术对脊髓损伤无效。需要更多的临床数据，以随机对照研究的形式，以了解硬膜切开术和骨髓切开术的有效性。骨髓切开术程序在80％的动物研究中均有效，但只有一项骨髓切开术的临床研究报告了对人体运动和感觉改善的积极结果。但是，许多新的动物研究报告说，硬膜切开术和骨髓切开术对脊髓损伤无效。需要更多的临床数据，以随机对照研究的形式，以了解硬膜切开术和骨髓切开术的有效性。
Current management for spinal cord injury aims to reduce secondary damage and recover sensation and movement. Acute spinal cord injury is often accompanied by spinal cord compartment syndrome. Decompression by durotomy and/or myelotomy attempts to relieve secondary damage by completelyrelieving the compression of the spinal cord, removing the necrotic tissue, decreasing edema, reducing hemorrhage, and improving blood circulation in the spinal cord. However, it is controversial whether durotomy and/or myelotomy after spinal cord injury are beneficial to neurological recovery. This review compares the clinical effects of durotomy with those of myelotomy in the treatment of spinal cord injury. We found that durotomy has been performed more than myelotomy in the clinic, and that durotomy may be safer and more effective than myelotomy. Durotomy performed in humans had positive effects on neurological function in 92.3% of studies in this review, while durotomy in animals had positive effects on neurological function in 83.3% of studies. Myelotomy procedures were effective in 80% of animal studies, but only one clinical study of myelotomy has reported positive results, of motor and sensory improvement, in humans. However, a number of new animal studies have reported that durotomy and myelotomy are ineffective for spinal cord injury. More clinical >
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