《中国康复理论与实践》

《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (3): 282-284.

• 论文 • 上一篇    下一篇

非创伤性脊髓损伤的临床特点

李想，洪毅，张军卫，唐和虎，刘舒佳，吕振，陈世铮   

  1. 1.首都医科大学康复医学院，北京市100068；2.中国康复研究中心北京博爱医院脊柱脊髓外科，北京市100068。
  • 收稿日期:2013-11-26 修回日期:2013-12-24 出版日期:2014-03-25 发布日期:2014-03-25
  • 通讯作者: 洪毅

Clinical Characteristics for Nontraumatic Spinal Cord Injury

LI Xiang, HONG Yi, ZHANG Jun-wei, et al.   

  1. Capital Medical University School of Rehabilitation Medicine, Department of Spine and Spinal Cord Surgery, Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China
  • Received:2013-11-26 Revised:2013-12-24 Published:2014-03-25 Online:2014-03-25

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被引次数

10

摘要： 目的探讨非创伤性脊髓损伤患者的人口学特征、病因学分布以及神经功能预后。方法对44 例非创伤性因素造成的脊髓损伤患者的临床资料进行回顾性分析。结果患者均获得3 个月以上随访，平均随访时间13.3 个月(3~23 个月)。其中男性27 例(61.3%)，女性17 例(38.7%)；平均年龄39.85 岁(3.5~78 岁)。病因包括脊髓炎16 例(36%)，脊柱肿瘤8 例(18.1%)，椎管内肿瘤7例(15.9%)，脊髓血管畸形6 例(13.6%)，非创伤性椎间盘突出3 例(6.8%，包括颈椎间盘突出致四肢瘫1 例，腰椎间盘突出致马尾综合征2 例)，非脊柱手术造成的医源性脊髓缺血2 例(4.5%)，肝性脊髓病2 例(4.5%)。入院时神经损伤情况：颈段脊髓损伤9 例(20.4%)，胸段损伤30 例(68.1%)，圆锥综合征2 例(4.5%)，马尾综合征3 例(6.8%)。AISA 残损分级：A级14 例(31.8%)，B级6 例(13.6%)，C级13 例(29.5%)，D级11 例(25%)。最终随访时，34%患者出现至少1 个等级的神经功能恢复。结论非创伤性脊髓损伤是造成脊髓损伤的重要原因。因具有特殊的病因学特点，此组病例在人口学特征以及临床特点上与创伤性脊髓损伤患者有较大区别。

关键词: 非创伤性脊髓损伤, 病因学, 神经功能, 康复

Abstract: Objective To investigate the clinical characteristics of nontraumatic spinal cord injury, including the demographic characteristics,etiology and neurological function. Methods 44 patients with nontraumatic spinal cord injury in the past 4 years were reviewed. Results There were 27 males (61.3%) and 17 females (38.7%) with mean age of 39.85 years (3.5~78). They were followed up for mean of 13.3 (3~23) months. Myelitis (36%) and spinal tumor (including primary and metastatic tumor, 18.1%) were the most common causes, followed by intraspinal tumor (15.9%), vascular disease (13.6%), nontraumatic acute disc herination (6.8%), spinal cord ischemia after non-spinal surgery (4.5%) and hepatic myelopathy (4.5%). Neurological function at the initial admission included tetraplegia in 9 patients, paraplegia in 30 patients, conus medullaris syndrome in 2 patients and cauda equina syndrome in 2 patients. Neurological function of ASIA at the initial admission included A in 14 cases, B in 6, C in 13 and D in 11. 34% patients improved at least one ASIA grade when evaluated at final follow up. Conclusion Nontraumatic etiologies contribute to a significant proportion for spinal cord injury. Patients with nontraumatic spinal cord injury present the clinical characteristics different from traumatic spinal cord injury cases.

Key words: nontraumatic spinal cord injury, etiology, neurological function, rehabilitation