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对于颈脊髓损伤患者,手术改善手臂功能所带来的可接受的益处和风险。

Acceptable benefits and risks associated with surgically improving arm function in individuals living with cervical spinal cord injury.

作者信息

Anderson K D, Fridén J, Lieber R L

机构信息

Department of Neurological Surgery, Reeve-Irvine Research Center, University of California, Irvine, CA 92697-1385, USA.

出版信息

Spinal Cord. 2009 Apr;47(4):334-8. doi: 10.1038/sc.2008.148. Epub 2008 Nov 25.

Abstract

STUDY DESIGN

Secure, web-based survey.

OBJECTIVES

To determine how quadriplegics in the US view tendon transfer surgeries (TTS) and what activities of daily living (ADL) involving arm/hand function are important in improving quality of life (QoL).

SETTING

World wide web.

METHODS

Individuals >or=18 years of age living with a cervical spinal cord injury (SCI). Participants obtained a pass code to enter a secure website and answered survey questions. A total of 137 participants completed the survey.

RESULTS

Two-thirds of participants had injury levels between C4/5 and C5/6. Over 90% felt that improving their arm/hand function would improve their QoL. ADL that were ranked most important to regain were dressing, feeding, transferring in/out of bed, and handwriting. Less than half of the participants had never been told about TTS and only 9% had ever had TTS. Nearly 80% reported that they would be willing to spend 2-3 months being less independent, while recovering from surgery, to ultimately become more independent. Over 75% reported that the ideal time preferred to have TTS, if chosen, would be within 5 years post-injury.

CONCLUSION

Regaining arm and hand function is of primary importance to individuals with cervical SCI, in particular, to increase independence in multiple ADL. There is a critical need in the US to improve awareness of TTS as a viable option for improving arm/hand function in some people. This information needs to be provided early after injury so that informed choices can be made within the first 5 years.

摘要

研究设计

基于网络的安全调查。

目的

确定美国四肢瘫痪患者如何看待肌腱转移手术(TTS),以及涉及手臂/手部功能的哪些日常生活活动(ADL)对改善生活质量(QoL)很重要。

背景

万维网。

方法

年龄≥18岁的颈脊髓损伤(SCI)患者。参与者获得进入安全网站的密码并回答调查问题。共有137名参与者完成了调查。

结果

三分之二的参与者损伤水平在C4/5和C5/6之间。超过90%的人认为改善手臂/手部功能会提高他们的生活质量。恢复时最重要的ADL依次是穿衣、进食、上下床转移和书写。不到一半的参与者从未被告知过肌腱转移手术,只有9%的人做过该手术。近80%的人表示,他们愿意在术后恢复期间花费2至3个月减少独立性,以最终变得更加独立。超过75%的人表示,如果选择肌腱转移手术,理想的手术时间是在受伤后5年内。

结论

恢复手臂和手部功能对颈脊髓损伤患者至关重要,特别是为了提高在多种日常生活活动中的独立性。美国迫切需要提高对肌腱转移手术作为改善某些人手臂/手部功能的可行选择的认识。此信息需要在受伤后尽早提供,以便在受伤后的头5年内做出明智的选择。

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