Perrouin-Verbe B, Robert R, Lefort M, Agakhani N, Tadié M, Mathé J F
Pôle de Médecine Physique et de Réadaptation, Hôpital Saint-Jacques, CHU, Nantes.
Neurochirurgie. 1999 Jun;45 Suppl 1:58-66.
Clinical and neuroradiological data were recorded in a series of 73 spinal cord injured patients (33 in Nantes, 40 in Paris-Bicêtre) in whom a post traumatic syringomyelia (PTS) developed. These findings and a review of the literature allow to point out some of the main characteristics in such a pathology. Clinical symptoms are frequent, the commonest of them are pain and sensory loss but any alteration of the neurological status after spinal cord injury has to be considered. Magnetic resonance imaging (MRI), sagittal and axial T1 and T2 weighted images, confirms the diagnosis of syrinx (area with the same signal intensity as CSF extending beyond the site of the initial lesion at least on 2 vertebral segments). MRI allows the diagnosis when it is performed in the follow up of asymptomatic patients. So PTS is not infrequent in spinal cord injured patients, for some of them in the first year after the trauma. The highest incidence is found in patients with complete thoracic lesions. Pathophysiology and surgical management have to take into account post traumatic residual stenosis of the vertebral canal.
记录了73例发生创伤后脊髓空洞症（PTS）的脊髓损伤患者（南特33例，巴黎比塞特40例）的临床和神经放射学数据。这些发现以及文献回顾有助于指出这种病理状况的一些主要特征。临床症状很常见，其中最常见的是疼痛和感觉丧失，但脊髓损伤后神经状态的任何改变都必须予以考虑。磁共振成像（MRI），矢状面和轴位面T1加权和T2加权图像，可确诊脊髓空洞症（信号强度与脑脊液相同的区域至少在2个椎体节段超出初始损伤部位）。在无症状患者的随访中进行MRI检查时可作出诊断。因此，PTS在脊髓损伤患者中并不少见，其中一些患者在创伤后的第一年就会出现。发病率最高的是完全性胸段损伤患者。病理生理学和外科治疗必须考虑创伤后椎管残余狭窄的情况。
