中国神经再生研究(英文版) ›› 2020, Vol. 15 ›› Issue (10): 1814-1820.doi: 10.4103/1673-5374.280304

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硬脊膜切开与脊髓切开修复脊髓损伤效果的比较

  

  • 出版日期:2020-10-15 发布日期:2020-08-04

Effects of durotomy versus myelotomy in the repair of spinal cord injury

Dionne Telemacque, Feng-Zhao Zhu, Zheng-Wei Ren, Kai-Fang Chen, Deepak Drepaul, Sheng Yao, Fan Yang, Yan-Zheng Qu,#br# Ting-Fang Sun, Xiao-Dong Guo#br#   

  1. Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, China
  • Online:2020-10-15 Published:2020-08-04
  • Contact: Xiao-Dong Guo, MD, PhD,xiaodongguo@hust.edu.cn.
  • Supported by:
    This work was financially supported by the National Key Research and Development Program of China, No. 2016YFC1100100 (to XDG).

摘要: orcid: 0000-0001-9429-457X (Xiao-Dong Guo)

Abstract: 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 data, in the form of a randomized controlled study, are needed to understand the effectiveness of durotomy and myelotomy.

Key words: decompression, durotomy, intraspinal pressure, laminectomy, myelotomy, neurological recovery, spinal cord compartment syndrome, spinal cord injury, spinal cord interstitial pressure