Vogel Lawrence C, Mendoza Melissa M, Schottler Jennifer C, Chlan Kathleen M, Anderson Caroline J
SCI Program, Shriners Hospitals for Children, 2211 N. Oak Park Avenue, Chicago, IL 60707-3392, USA.
J Spinal Cord Med. 2007;30 Suppl 1(Suppl 1):S158-64. doi: 10.1080/10790268.2007.11754595.
To delineate the natural history of ambulation of children and youth with spinal cord injuries (SCls).
Retrospective single-center.
PARTICIPANTS/METHODS: One hundred sixty-nine subjects who sustained SCI at 18 years of age or younger and who were followed up for at least 4 years.
Ambulation was significantly associated with age at injury and neurological impairment but not gender. Younger age at injury was associated with greater likelihood of ambulation, higher level of ambulation, and greater duration of ambulation. Lesser severity of neurological impairment was associated with greater likelihood of ambulation. Excluding ASIA D lesions, household ambulation was noted in 5% of subjects with tetraplegic, 26% with high thoracic, 30% with low thoracic, 44% with upper lumbar, and 33% with lower lumbar lesions. Of the 7 community-level ambulators with non-ASIA D lesions, none had cervical or high thoracic injuries, 3 had low thoracic, 1 had upper lumbar, and 3 had lower lumbar lesions. Using multiple regression analysis, predictive factors for ambulation were younger age at injury, total ASIA motor score, and ASIA impairment scale score. Less cumbersome orthotics were associated with higher levels of ambulation.
Ambulation status is a function of neurological impairment, age at injury, and type of orthotic.
描绘脊髓损伤（SCI）儿童和青少年的行走自然史。
回顾性单中心研究。
参与者/方法：169名18岁及以下发生脊髓损伤且随访至少4年的受试者。
行走能力与受伤时年龄和神经功能障碍显著相关，但与性别无关。受伤时年龄越小，行走的可能性越大、行走水平越高、行走持续时间越长。神经功能障碍严重程度越低，行走的可能性越大。排除ASIA D级损伤，在四肢瘫受试者中5%能在家中行走，高位胸椎损伤者中26%，低位胸椎损伤者中30%，上腰椎损伤者中44%，下腰椎损伤者中33%。在7名非ASIA D级损伤的社区水平行走者中，无人有颈椎或高位胸椎损伤，3人有低位胸椎损伤，1人有上腰椎损伤，3人有下腰椎损伤。采用多元回归分析，行走的预测因素为受伤时年龄较小、ASIA运动总分和ASIA损伤量表评分。较轻便的矫形器与更高的行走水平相关。
行走状态是神经功能障碍、受伤时年龄和矫形器类型的函数。
