Gerhart K A, Johnson R L, Whiteneck G G
Craig Hospital, Englewood, Colorado 80110.
Paraplegia. 1992 Apr;30(4):282-7. doi: 10.1038/sc.1992.70.
Longitudinal data and clinical experience indicate that a greater proportion of spinal cord injuries result in incomplete or resolving neurological lesions. Although it has been reported that persons with incomplete injuries enjoy better functional outcomes, routine contacts with these individuals indicate that many experience problems and complications strikingly similar to those with complete spinal cord injuries. Thus, to document the issues and needs of these individuals, data from Colorado's population-based spinal cord injury surveillance program were analyzed. Of 330 persons registered since January 1, 1986, 121 (37%) were found to be minimally disabled (Frankel class D or E). Review of medical records and follow up documentation for these individuals indicated that although over 75% were ambulatory and virtually all were physically independent, more than 80% did report problems in one or more areas: 21% had orthopedic issues and 17% faced additional spinal surgery; 16% reported neurological deterioration or increased spasticity; 25% had pain problems; and 16% had bladder difficulties. Other issues included bowel problems, blood pressure abnormalities, skin breakdown, sexual difficulties, depression, and unemployability. Implications for rehabilitation are discussed in the light of these and other findings.
纵向数据和临床经验表明，更大比例的脊髓损伤会导致不完全性或正在恢复的神经损伤。尽管有报道称不完全性损伤患者的功能预后更好，但与这些个体的日常接触表明，许多人经历的问题和并发症与完全性脊髓损伤患者惊人地相似。因此，为了记录这些个体的问题和需求，对科罗拉多州基于人群的脊髓损伤监测项目的数据进行了分析。在自1986年1月1日起登记的330人中，有121人（37%）被发现残疾程度最低（Frankel D级或E级）。对这些个体的病历回顾和随访记录表明，尽管超过75%的人能够行走，几乎所有人在身体方面都能自理，但超过80%的人确实报告了一个或多个方面的问题：21%有骨科问题，17%面临额外的脊柱手术；16%报告有神经功能恶化或痉挛加剧；25%有疼痛问题；16%有膀胱问题。其他问题包括肠道问题、血压异常、皮肤破损、性功能障碍、抑郁和无法就业。根据这些及其他研究结果讨论了对康复的启示。
