Vilela Marcelo D, Goodkin Robert
Department of Neurological Surgery, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA.
Surg Neurol. 2009 Nov;72(5):505-8; discussion 508. doi: 10.1016/j.surneu.2009.02.003. Epub 2009 Jul 15.
Because of the rarity of cervicothoracic spine injuries, detailed reports on the neurologic examination after complete cord injuries are scarce. A few retrospective case series scantily documented the intrinsic hand function after C7-T1 complete cord injuries. A complete cervical cord injury with useful C8 and T1 motor function present immediately after the injury has not been reported to date.
Functional C8 and T1 motor strength at the time of the initial neurologic examination was seen in 2 cases in which a complete C7-T1 injury resulted in paraplegia. Serial neurologic examinations were performed to document useful C8 and T1 motor function and maintenance of the neurologic status after surgical treatment.
Patients can present with useful lower cervical root function (C8 and T1) when first seen at admission after a complete cervical cord injury. Careful neurologic examination must be performed at admission in patients with lower cervical spine injuries because useful intrinsic hand function can be present and must not be overlooked.
由于颈胸段脊柱损伤较为罕见，关于完全性脊髓损伤后神经学检查的详细报告很少。少数回顾性病例系列对C7-T1完全性脊髓损伤后的手部内在功能记录甚少。迄今为止，尚未有关于损伤后立即出现有用的C8和T1运动功能的完全性颈髓损伤的报道。
在2例因C7-T1完全性损伤导致截瘫的患者中，初次神经学检查时发现了功能性C8和T1肌力。进行了系列神经学检查，以记录有用的C8和T1运动功能以及手术治疗后神经状态的维持情况。
完全性颈髓损伤患者入院初诊时可能存在有用的下颈神经根功能（C8和T1）。对于下颈椎损伤患者，入院时必须进行仔细的神经学检查，因为可能存在有用的手部内在功能，不可忽视。
