Byers R K
Dev Med Child Neurol. 1975 Feb;17(1):103-10. doi: 10.1111/j.1469-8749.1975.tb04967.x.
The subject of perinatal injury to the spinal cord is briefly reviewed. Recognized causative factors are traction on the infant's trunk during breech delivery, rotational stresses applied to the spinal axis, traction on the cord via the brachial plexus in shoulder dystocia, and hyperextension of the fetal head in breech delivery or transverse presentation. Recognition of these factors is the basis for prevention of this terrible accident. Diagnostic criteria at various period of life are mentioned and the importance of the recognition of anaesthesia and reflex movements is emphasized. Treatment is mainly supportive. The development of an automatic reflex bladder evacuation is discussed. Follwup examinations and resourceful orthopedic care are essential. A few affected children learn to live with their disability and a very few who are apparently transected at birth recover surprisingly well.
本文简要回顾了围产期脊髓损伤这一主题。已确认的致病因素包括臀位分娩时对婴儿躯干的牵引、施加于脊柱轴的旋转应力、肩难产时通过臂丛神经对脊髓的牵引，以及臀位分娩或横位产时胎儿头部的过度伸展。认识到这些因素是预防这一可怕事故的基础。文中提到了不同生命阶段的诊断标准，并强调了识别麻醉和反射运动的重要性。治疗主要是支持性的。文中讨论了自动反射性膀胱排空的发展。随访检查和巧妙的骨科护理至关重要。一些受影响的儿童学会了与残疾共处，少数在出生时看似脊髓横断的儿童恢复得惊人地好。
