Saeidiborojeni Hamid Reza, Moradinazar Mehdi, Saeidiborojeni Sepehr, Ahmadi Alireza
Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Inj Violence Res. 2013 Jan;5(1):70-4. doi: 10.5249/jivr.v5i1.277. Epub 2012 Aug 21.
Penetrating spinal cord injuries (SCIs) are an uncommon injury and not reported very frequently. SCIs cause sensory, motor and genitourinary system problems or a combination of sensorimotor dysfunctions. These are among the most debilitating kinds of disorders and negatively affect quality of life, not only for the patient, but also for their family members. Therefore, the present study aims to evaluate complete or incomplete SCIs and the course of the injury and the prognosis for SCIs caused by stab wounds.
This case-series design study was performed on 57 patients attending the emergency department of Taleqani Trauma Center (Kermanshah, Iran) due to SCIs caused by violent encounters involving sharp objects such as a knife, dagger, whittle and Bowie-knife between 1999 and 2011. An assessment of sensory and motor functions was performed as part of the neurological examination on admission, and during the treatment, using the Frankel Classification grading system, and the results were recorded.
The average age of patients was 27 years (SD= 7.9, Range=17 to 46 years). The results of the study showed a proportion of cervical, thoracic and lumbar injuries of 23 (40%), 24 (42%) and 10 (18%), respectively. There was no case of cerebrospinal fluid leakage (CSF) or infection at the wound site in the subjects. Regarding the extent of the SCI, the combined neurological assessment showed that several patients (43%) had a complete SCI with no sensory and motor functions in the sacral segments and the segments below the site of injury. In 32 patients (57%) incomplete injuries were observed; i.e. they showed only some degrees of sensory-motor functions that were below the neurological level.
Both complete and incomplete SCIs are of great importance because the prognosis of SCI is directly associated with the location and extent of injury. It should be considered that partial recovery from SCIs is possible in few cases of complete injuries. Therefore, all the patients should be treated carefully and seriously.
穿透性脊髓损伤（SCI）是一种罕见的损伤，报告频率不高。脊髓损伤会导致感觉、运动和泌尿生殖系统问题，或感觉运动功能障碍的组合。这些是最使人衰弱的疾病类型之一，不仅对患者，而且对其家庭成员的生活质量都有负面影响。因此，本研究旨在评估完全性或不完全性脊髓损伤、损伤过程以及刺伤所致脊髓损伤的预后。
本病例系列设计研究对1999年至2011年间因刀、匕首、削刀和猎刀等锐器暴力冲突导致脊髓损伤而到塔莱加尼创伤中心（伊朗克尔曼沙阿）急诊科就诊的57例患者进行。入院时及治疗期间，作为神经学检查的一部分，使用弗兰克尔分类分级系统对感觉和运动功能进行评估，并记录结果。
患者的平均年龄为27岁（标准差=7.9，范围=17至46岁）。研究结果显示，颈椎、胸椎和腰椎损伤的比例分别为23例（40%）、24例（42%）和10例（18%）。受试者伤口部位无脑脊液漏（CSF）或感染病例。关于脊髓损伤的程度，综合神经学评估显示，数名患者（43%）为完全性脊髓损伤，骶段及损伤部位以下无感觉和运动功能。在32例患者（57%）中观察到不完全损伤；即他们仅表现出低于神经水平的某种程度的感觉运动功能。
完全性和不完全性脊髓损伤都很重要，因为脊髓损伤的预后与损伤的部位和程度直接相关。应考虑到在少数完全性损伤病例中脊髓损伤有可能部分恢复。因此，所有患者都应得到认真且严肃的治疗。
