Abel R, Cerrel Bazo H A, Kluger P J, Selmi F, Meiners T, Vaccaro A, Ditunno J, Gerner H J
Orthopädische Universitätsklinik, Abteilung 2, Heidelberg, Germany.
Spinal Cord. 2003 Apr;41(4):211-9. doi: 10.1038/sj.sc.3101435.
We describe the case of a 47-year-old female who sustained a C5/6 fracture with C6 complete spinal cord injury 26 years ago. She presented with increased spasticity of the lower extremities, the abdominal wall and episodes of autonomic dysreflexia. Imaging of the spine revealed post-traumatic kyphosis at the level of the injury and degenerative changes of the lumbar spine with marked facet joint hypertrophy at the level of L4/5 causing severe spinal canal stenosis. Discussants of this case comment on the possible pathophysiological mechanisms causing autonomic dysreflexia, especially the development of degenerative changes, Charcot arthropathy and the role of tethering mechanisms. The diagnostic options and management approaches are also discussed.
我们描述了一名47岁女性的病例，她在26年前发生了C5/6骨折并伴有C6完全性脊髓损伤。她出现了下肢、腹壁痉挛加重以及自主神经反射异常发作的症状。脊柱影像学检查显示损伤节段存在创伤后脊柱后凸，腰椎有退行性改变，L4/5水平小关节显著肥大，导致严重的椎管狭窄。该病例的讨论者对引起自主神经反射异常的可能病理生理机制进行了评论，尤其是退行性改变、夏科关节病的发展以及牵拉机制的作用。还讨论了诊断方法和治疗方案。
