de Miguel Marcia, Kraychete Durval Campos
Especialista em Dor - Universidade Salvador (UNIFACS); Farmacêutica Hospitalar - Rede SARAH de Hospitais de Reabilitação. marciademiguel @ sarah.br
Rev Bras Anestesiol. 2009 May-Jun;59(3):350-7. doi: 10.1590/s0034-70942009000300011.
Chronic pain after spinal cord injury is a highly prevalent clinical condition, which is difficult to treat. Therefore, it is important to know its clinical characteristics and causes for a better diagnostic and therapeutic approach. The objective of this study was to review the literature on pain in patients with spinal cord injury and the possible association with physical (level of the injury, completeness of lesion, pain duration) and psychological (mood and quality of life) factors.
Original studies in the Medline database with patients older than 18 years and published over the last six years were reviewed. The clinical characteristics of pain in patients with spinal cord injury are discussed, and the works of several authors are compared.
Despite conceptual and methodological differences among the studies, the prevalence of pain in patients with spinal cord injury was high, varying from 64% to 82%. Neuropathic pain at the level of the injury has an early onset (days or weeks), while that below the level of the injury has a late onset (months or years). An association between pain and integrity of the lesion is not observed, and the percentage of patients who complain of severe pain varies from 21% to 39%. It was not possible to conclude which is the relationship between pain and level of spinal cord injury. However, pain can have a negative influence on mood and in the capacity to perform cognitive, social, recreational, and work-related activities.
脊髓损伤后的慢性疼痛是一种非常普遍的临床病症，难以治疗。因此，了解其临床特征和病因对于采取更好的诊断和治疗方法至关重要。本研究的目的是回顾关于脊髓损伤患者疼痛以及与身体因素（损伤平面、损伤完整性、疼痛持续时间）和心理因素（情绪和生活质量）可能关联的文献。
对Medline数据库中过去六年发表的、患者年龄大于18岁的原始研究进行了回顾。讨论了脊髓损伤患者疼痛的临床特征，并比较了几位作者的研究成果。
尽管各项研究在概念和方法上存在差异，但脊髓损伤患者疼痛的患病率较高，在64%至82%之间。损伤平面的神经性疼痛发病较早（数天或数周），而损伤平面以下的神经性疼痛发病较晚（数月或数年）。未观察到疼痛与损伤完整性之间的关联，主诉严重疼痛的患者比例在21%至39%之间。无法确定疼痛与脊髓损伤平面之间的关系。然而，疼痛会对情绪以及进行认知、社交、娱乐和工作相关活动的能力产生负面影响。
