Practice of Evidence-based Treatment Strategy for Cervical Spinal Cord Injury_West China Medical Journal

Authors：

 DUZhi-po , ZHAOHong-wei , GAOJian-gang , ZHANGJing-bin

Department of Spine Surgery, the People's Hospital of Tang County, Tang County, Heibei 072350, P. R. China;

Corresponding?author：

Keywords：

Cervical spinal cord injury; Evidence-based treatment; Practical strategies; Case report; Clinical result

DOI：

10.7507/1002-0179.20140274

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Objective To explore the practice of the evidence-based treatment strategy for cervical spinal cord injury. Methods One patient with cervical spinal cord injury was admitted to our hospital on January 3, 2013. We obtained medical evidences by searching databases and regulated the best treatment after evaluating the patient's comprehensive conditions. And then, the whole treatment strategy was fully implemented. Finally, the consequent results were evaluated. Results The evidence-based medicine showed that the therapeutic targets were to save the residual function, prevent complications, and promote the recovery of neural function. Based on the real-time conditions of patient, we developed and practiced the evidence-based comprehensive rehabilitation programs, including absolute rest in bed, high-dose steroids, neurotrophic drugs, Chinese medicine rehabilitation and prevention of complications. After a follow-up of half a year, the patient obtained a good curative effect. The patient was saved from paralyzing. Moreover, the patient restored the capacity of standing, walking and a certain level of self-care ability. Conclusion For the cervical spinal cord injury, treatment decision based on evidence-based medicine is more scientific, and it can ensure maximum benefit for the patients. Therefore, it is worthy of popularizing.

Citation： DUZhi-po, ZHAOHong-wei, GAOJian-gang, ZHANGJing-bin. Practice of Evidence-based Treatment Strategy for Cervical Spinal Cord Injury. West China Medical Journal, 2014, 29(5): 904-906. doi: 10.7507/1002-0179.20140274 Copy

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1. Diaz-Ruiz A, Alcaraz-Zubeldia M, Maldonado V, et al. Differential time-course of the increase of antioxidant thiol-defenses in the acute phase after spinal cord injury in rats[J]. Neurosci Lett, 2009, 452(1):56-59.
2. Sharma HS. Pathophysiology of blood-spinal cord barrier in traumatic injury and repair[J]. Curr Pharm Des, 2005, 11(11):1353-1389.
3. 胥少汀, 葛寶豐, 徐印坎. 實用骨科學[M]. 3版. 北京:人民軍醫出版社, 2009:534-579.
4. 劉智, 孫天勝, 李京生, 等. 早期手術治療急性頸脊髓損傷[J]. 中華創傷骨科雜志, 2004, 1(11):10-12.
5. Bracken MB. Steroids for acute spinal cord injury[J]. Cochrane Database Syst Rev, 200, (3):CD001046.
6. Petitjean ME, Pointillart V, Dixmerias F, et al. Medical treatment of spinal cord injury in the acute stage[J]. Ann Fr Anesth Reanim, 1998, 17(2):114-122.
7. 邱有波, 袁夢郎, 楊拯, 等. 硫酸鎂聯合單唾液酸神經節苷脂對脊髓損傷大鼠運動功能恢復的影響[J]. 中國康復理論與實踐, 2011, 17(2):137-140.
8. 王麗娜, 劉芳, 張偉玲, 等. 神經節苷脂對大鼠急性脊髓損傷后bcl-2 mRNA表達的影響[J]. 中國急救醫學, 2006, 26(9):680-681.
9. Gorria M, Huc L, Sergent O, et al. Protective effect of monosialoganglioside GM1 against chemically induced apoptosis through targeting of mitochondrial function and Iron transport[J]. Biochem Pharmacol, 2006, 72(10):1343-1353.
10. 張強, 鄒德威. 腦源性神經營養因子轉基因細胞移植和神經節苷脂對大鼠脊髓損傷N-甲基-D-天門冬氨酸受體的影響[J]. 中華創傷骨科雜志, 2006, 8(2):162-164.
11. 李花, 陳安, 李亮, 等. 三七總皂苷對大鼠脊髓損傷后GS的表達及運動功能恢復的影響[J]. 湖南中醫藥大學學報, 2012, 32(1):23-26, 30.
12. 曹中華, 王金光. 脊髓損傷治療進展[J]. 海南醫學, 2012, 23(6):123-128.
13. 楊清芬, 黃紹梅, 邱薇. 穴位針刺治療小兒結核性腦膜炎后面癱、肢體癱瘓30例臨床觀察[J]. 現代醫院, 2009, 9(4):68-69.
14. 林琳, 牛秀連. 針灸為主治療小兒腦癱語言障礙的臨床研究[J]. 國際中醫中藥雜志, 2008, 30(2):144-145.
15. Dooling E, Winkelman C. Hyponatremia in the patient with subarachnoid hemorrhage[J]. Neurosci Nurs, 2004, 36(3):130-135.
16. Amini A, Schmidt MH. Syndrome of inappropriate secretion of antidiuretic hormone and hyponatremia after spinal surgery[J]. Neurosurg Focus, 2004, 16(4):E10.
17. Engoren M, Arslanian EC, Fenn BN. Hospital and long-term outcome after tracheostomy for respiratory failure[J]. Chest, 2004, 125(1):220-227.
18. 王波, 孫平, 陳飛翔. 頸椎損傷后高位截癱合并呼吸衰竭28例救治體會[J]. 人民軍醫, 2007, 50(3):154.

West China Medical Journal

Practice of Evidence-based Treatment Strategy for Cervical Spinal Cord Injury

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