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脊髓损伤的滑翔伞事故:一家机构的10年经验。

Paragliding accidents with spinal cord injury: 10 years' experience at a single institution.

作者信息

Gauler Rolf, Moulin Patrick, Koch Hans G, Wick Lukas, Sauter Benno, Michel Dieter, Knecht Hans

机构信息

Medical Clinic, Swiss Paraplegic Centre, Nottwil, Switzerland.

出版信息

Spine (Phila Pa 1976). 2006 May 1;31(10):1125-30. doi: 10.1097/01.brs.0000216502.39386.70.

Abstract

STUDY DESIGN

A retrospective analysis of 41 patients with spinal cord injury (SCI) after paragliding accidents.

OBJECTIVE

To determine the lesioned pattern and prognostic radiologic factors for rehabilitation potential.

SUMMARY OF BACKGROUND DATA

Paragliding accidents with SCI present a new injury pattern, dealt with in the current literature from a purely orthopedic, sports medicine, or insurance point of view. Few combinations of orthopedic and neurologic data are available.

METHODS

Over a 10-year period, the case records of 41 patients with SCI caused by paragliding accidents were analyzed with regard to vertebral and other skeletal fractures, neurologic recovery (American Spine Injury Association score), and professional reintegration.

RESULTS

Vertebral fractures peaked in the thoracolumbar region, with L1 most frequently (30%) affected. The levels of vertebral lesion and neurologic deficit differed in 32% of patients. Combination with lower-limb fractures was characteristic for paragliding SCI (P < 0.001); 93% of patients with initial bony occlusion of the spinal canal of <70% left the clinic ambulatory.

CONCLUSION

Paragliding accidents with SCI show a characteristic injury pattern associated with a high recovery potential if the initial bony spinal canal occlusion is <70%. Half the patients will reintegrate in their former profession and place of employment.

摘要

研究设计

对41例滑翔伞事故后脊髓损伤(SCI)患者进行回顾性分析。

目的

确定损伤模式及康复潜力的预后放射学因素。

背景资料总结

伴有脊髓损伤的滑翔伞事故呈现出一种新的损伤模式,当前文献仅从纯骨科、运动医学或保险角度进行探讨。骨科和神经学数据的综合分析较少。

方法

在10年期间,对41例因滑翔伞事故导致脊髓损伤患者的病例记录进行分析,内容包括椎体及其他骨骼骨折、神经功能恢复情况(美国脊髓损伤协会评分)以及职业再融入情况。

结果

椎体骨折在胸腰段最为常见,L1椎体受累最为频繁(30%)。32%的患者椎体损伤水平与神经功能缺损情况不同。合并下肢骨折是滑翔伞脊髓损伤的特征(P < 0.001);初始椎管骨性狭窄小于70%的患者中,93%出院时可独立行走。

结论

伴有脊髓损伤的滑翔伞事故呈现出一种特征性损伤模式,若初始椎管骨性狭窄小于70%,则具有较高的恢复潜力。半数患者能够重新回到原职业岗位和工作地点。

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