McDonald John W, Sadowsky Cristina
Department of Neurology, Spinal Cord Injury Neuro-Rehabilitation Section, and Restorative Treatment and Research Program, Washington University School of Medicine, St Louis, MO 63110, USA.
Lancet. 2002 Feb 2;359(9304):417-25. doi: 10.1016/S0140-6736(02)07603-1.
More than a decade ago, spinal-cord injury meant confinement to a wheelchair and a lifetime of medical comorbidity. The physician's armamentarium of treatments was very limited, and provision of care for individuals with spinal-cord injury was usually met with frustration. Advances in the neurosciences have drawn attention to research into spinal-cord injury. Nowadays, advanced interventions provide high hope for regeneration and functional restoration. As scientific advances become more frequent, scepticism is giving way to the ideas that spinal-cord injury will eventually be repairable and that strategies to restore function are within our grasp. We address the present understanding of spinal-cord injury, its cause, pathophysiology, diagnosis, and treatment, and look at promising research avenues. We also discuss new treatment options, including functional electric stimulation and part-weight-supported walking.
十多年前,脊髓损伤意味着要终身坐在轮椅上并伴有多种医疗合并症。医生的治疗手段非常有限,为脊髓损伤患者提供护理往往令人沮丧。神经科学的进展使人们将注意力转向了脊髓损伤的研究。如今,先进的干预措施为再生和功能恢复带来了很高的希望。随着科学进展越来越频繁,怀疑态度正在让位于这样的观点,即脊髓损伤最终将是可修复的,并且恢复功能的策略也在我们的掌握之中。我们阐述了目前对脊髓损伤的认识、其病因、病理生理学、诊断和治疗,并探讨了有前景的研究途径。我们还讨论了新的治疗选择,包括功能性电刺激和部分体重支撑步行。