Tully J G, Latteri A
Clin Orthop Relat Res. 1978 Jul-Aug(134):244-8.
A casually related triad of syringomyelia tarda, postparaplegia with secondary neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder in 2 of our paraplegic patients prompted us to look for a correlation and/or a common etiology. Paraplegia secondary to spinal cord injury could be causative or at least an associated factor in a delayed proximal syringomyelia. It is the syringomyelia which can lead to the neuropathic arthrosis in the upper extremity, mainly, in the shoulder. There is an interesting pathological association of paraplegia and syringomyelia with neuropathic arthrosis. Earlier awareness of any neurological changes in the upper extremity of the paraplegic patient could point to recognition of syringomyelic process and portend a tendency toward neuropathic arthrosis of the shoulder. This would require a high index of suspicion, and subsequently a preventative, protective orthopedic approach to minimize the usual functional deformity that occurs when this neuropathy involves the shoulder.
本文报告了迟发性脊髓空洞症、截瘫后并发肩部继发性神经性关节病这一偶然相关的三联征。文中介绍了肩部神经性关节病的发展情况。我们的2例截瘫患者出现肩部神经性关节病,促使我们探寻其相关性和/或共同病因。脊髓损伤继发的截瘫可能是迟发性近端脊髓空洞症的病因,或至少是相关因素。正是脊髓空洞症可导致上肢,主要是肩部出现神经性关节病。截瘫、脊髓空洞症与神经性关节病之间存在有趣的病理关联。对截瘫患者上肢任何神经学变化的早期认识,可能提示脊髓空洞症的发生,并预示有肩部神经性关节病的倾向。这需要高度的怀疑指数,随后采取预防性、保护性的骨科方法,以尽量减少这种神经病变累及肩部时通常会出现的功能畸形。