Urgent management of quadriplegia following Sichuan earthquake under field condition / 第二军医大学学报

ABSTRACT

Objective: To explore the urgent management strategy for quadriplegia following China Wenchuan earthquake under filed condition. Methods: The 57-year-old male patient was sent to the earthquake relief team of Changzheng Hospital, Second Military Medical University. He was hit by heavy object during the Sichuan earthquake 6 days ago. Physical examination revealed cervical spinal cord injury accompanied by incomplete paralysis. The patient underwent cervical 3-7 laminectomy under general anesthesia. Results: After surgery the muscle strength of lower limbs recovered to grade four from grade one; the muscle strength of upper limbs recovered to grade five from grade three. Sensory loss was found below the nipple level and totally recovered after operation. Conclusion: Early surgery for quadriplegia following earthquake trauma can timely relieve compression to the spinal cord and therefore improve prognosis of patients. Under field condition where facilities are not readily available, decompression of spinal cord can be achieved by laminectomy via posterior approach. The key to successful operation is correct diagnosis and skillful manipulation.