Vogel Lawrence C, Krajci Katherine A, Anderson Caroline J
Shriners Hospitals for Children, Chicago, Illinois, USA.
J Spinal Cord Med. 2002 Summer;25(2):117-23. doi: 10.1080/10790268.2002.11753611.
To determine the prevalence of musculoskeletal and neurological complications of adults with pediatric-onset spinal cord injuries (SCI), and their association with demographic, impairment, and functional limitation factors.
Structured interview including standardized measures.
Individuals who sustained SCI at < or = age 18 years and were > or = age 24 years at interview.
Prevalence of musculoskeletal and neurological complications: fractures during the past 3 years; scoliosis; heterotopic ossification; hip dislocation or contractures; ankle contractures or pain; shoulder pain; elbow contractures or pain; pain at other sites; neurological deterioration; syringomyelia; and spasticity since injury.
The 216 individuals who were interviewed had mean age at injury of 14 years and mean age at follow-up of 29 years. Most common complications were pain at any site (69%), spasticity (57%), shoulder pain (48%), scoliosis (40%), hip contractures (23%), and back pain (22%). There were no statistically significant associations between gender and the complications. Whites were more likely than nonwhites to experience pain. Younger age at injury was significantly associated with scoliosis and hip subluxation, and older age at injury was associated with ankle pain and spasticity. Older age at follow-up and longer duration of injury were both associated with elbow and shoulder pain, fractures, and neurological deterioration. Longer injury duration was also associated with hip subluxation and scoliosis. Ankle pain, elbow contractures, and spasticity were more common in those with tetraplegia, and hip contractures were associated with paraplegia. American Spinal Injury Association motor scores were significantly lower in those with elbow contractures and spasticity, and significantly higher in those with hip contractures and neurological deterioration.
Musculoskeletal and neurological complications are common sequelae among adults with pediatric-onset SCI. Demographic, impairment, and functional limitation factors are associated with these complications and can identify at-risk individuals.
确定儿童期发病的脊髓损伤（SCI）成年患者肌肉骨骼和神经并发症的患病率，以及这些并发症与人口统计学、损伤和功能受限因素之间的关联。
采用包括标准化测量的结构化访谈。
18岁及以下发生SCI且在访谈时年龄为24岁及以上的个体。
肌肉骨骼和神经并发症的患病率：过去3年内的骨折；脊柱侧凸；异位骨化；髋关节脱位或挛缩；踝关节挛缩或疼痛；肩部疼痛；肘部挛缩或疼痛；其他部位疼痛；神经功能恶化；脊髓空洞症；以及受伤后的痉挛状态。
接受访谈的216名个体受伤时的平均年龄为14岁，随访时的平均年龄为29岁。最常见的并发症是任何部位的疼痛（69%）、痉挛状态（57%）、肩部疼痛（48%）、脊柱侧凸（40%）、髋关节挛缩（23%）和背痛（22%）。性别与并发症之间无统计学显著关联。白人比非白人更易出现疼痛。受伤时年龄较小与脊柱侧凸和髋关节半脱位显著相关，受伤时年龄较大与踝关节疼痛和痉挛状态相关。随访时年龄较大和受伤时间较长均与肘部和肩部疼痛、骨折及神经功能恶化相关。受伤时间较长还与髋关节半脱位和脊柱侧凸相关。踝关节疼痛、肘部挛缩和痉挛状态在四肢瘫患者中更常见，髋关节挛缩与截瘫相关。伴有肘部挛缩和痉挛状态的患者美国脊髓损伤协会运动评分显著较低，伴有髋关节挛缩和神经功能恶化的患者评分显著较高。
肌肉骨骼和神经并发症是儿童期发病的SCI成年患者常见的后遗症。人口统计学、损伤和功能受限因素与这些并发症相关，可用于识别高危个体。
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