Noonan Vanessa K, Kopec Jacek A, Zhang Hongbin, Dvorak Marcel F
Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
Arch Phys Med Rehabil. 2008 Jun;89(6):1074-82. doi: 10.1016/j.apmr.2007.10.041.
To determine the effect of associated spinal cord injury (SCI) conditions on the health status and quality of life (QOL) in people with traumatic central cord syndrome.
Cross-sectional design.
Community-based.
Subjects (N=70) with traumatic central cord syndrome who were a minimum of 2 years postinjury.
Not applicable.
Presence of associated SCI conditions (neuropathic pain, spasticity, bowel, bladder, and/or sexual dysfunction, decreased motor function); health status (36-Item Short-Form Health Survey [SF-36], symptom satisfaction); and QOL.
The SF-36 physical component score (PCS) was lower in subjects who reported problems with bowel, bladder, and/or sexual function (-6.9; 95% confidence interval [CI], -11.6 to -2.2). The PCS was decreased in subjects with a lower motor score and this relationship was negatively affected by spasticity and being less educated. The SF-36 mental component score was negatively affected by neuropathic pain and a lower motor score. Neuropathic pain and a lower motor score were both associated with subjects being dissatisfied with their symptoms. Subjects who had a higher motor score were more likely to have a higher QOL (odds ratio, 1.7; 95% CI, 1.1 to 2.7).
The associated SCI conditions bowel, bladder, and/or sexual dysfunction, neuropathic pain, decreased motor function, and spasticity negatively affect the health status of persons with traumatic central cord syndrome. Diminished motor recovery was the only associated SCI condition to impact QOL. By developing a conceptual model and adjusting for confounders, an estimate for each associated SCI condition's effect on patient outcomes was obtained. Our results indicate the importance of treating or ameliorating associated SCI conditions in order to maximize physical and mental functioning.
确定合并脊髓损伤（SCI）情况对创伤性中央脊髓综合征患者健康状况和生活质量（QOL）的影响。
横断面设计。
基于社区。
70例创伤性中央脊髓综合征患者，受伤至少2年。
不适用。
合并SCI情况（神经性疼痛、痉挛、肠道、膀胱和/或性功能障碍、运动功能减退）；健康状况（36项简短健康调查[SF-36]、症状满意度）；以及生活质量。
报告有肠道、膀胱和/或性功能问题的患者，其SF-36身体成分得分（PCS）较低（-6.9；95%置信区间[CI]，-11.6至-2.2）。运动得分较低患者的PCS降低，且这种关系受到痉挛和受教育程度较低的负面影响。SF-36精神成分得分受到神经性疼痛和较低运动得分的负面影响。神经性疼痛和较低运动得分均与患者对症状不满意有关。运动得分较高的患者更有可能具有较高的生活质量（优势比，1.7；95%CI，1.1至2.7）。
合并的SCI情况，即肠道、膀胱和/或性功能障碍、神经性疼痛、运动功能减退和痉挛，对创伤性中央脊髓综合征患者的健康状况产生负面影响。运动恢复减弱是唯一影响生活质量的合并SCI情况。通过建立概念模型并对混杂因素进行调整，获得了每种合并SCI情况对患者结局影响的估计值。我们的结果表明，治疗或改善合并的SCI情况对于最大限度地提高身心功能非常重要。
