Taghva Alexander, Hoh Daniel J, Lauryssen Carl L
Department of Neurological Surgery, University of Southern California, Los Angeles, CA, USA.
Handb Clin Neurol. 2012;109:105-30. doi: 10.1016/B978-0-444-52137-8.00007-3.
Spinal cord injury (SCI) is a significant public problem, with recent data suggesting that over 1 million people in the U.S.A. alone are affected by paralysis resulting from SCI. Recent advances in prehospital care have improved survival as well as reduced incidence and severity of SCI following spine trauma. Furthermore, increased understanding of the secondary mechanisms of injury following SCI has provided improvements in critical care and acute management in patients suffering from SCI, thus limiting morbidity following injury. In addition, improved technology and biomechanical understanding of the mechanisms of spine trauma have allowed further advances in available techniques for spinal decompression and stabilization. In this chapter we review the most recent data and salient literature regarding SCI and address current controversies, including the use of pharmacological adjuncts in the setting of acute SCI. We will also attempt to provide a reader with basic understanding of the classifications of SCI and spinal column injury. Finally, we review advances in spinal column stabilization including improvements in instrumented fusion and minimally invasive surgery.
脊髓损伤（SCI）是一个重大的公共卫生问题，最近的数据表明，仅在美国就有超过100万人受到脊髓损伤导致的瘫痪影响。院前护理的最新进展提高了生存率，并降低了脊柱创伤后脊髓损伤的发生率和严重程度。此外，对脊髓损伤后继发性损伤机制的深入了解，改善了脊髓损伤患者的重症监护和急性处理，从而限制了损伤后的发病率。此外，技术的进步以及对脊柱创伤机制的生物力学理解，推动了现有的脊柱减压和稳定技术的进一步发展。在本章中，我们回顾了关于脊髓损伤的最新数据和重要文献，并探讨了当前的争议，包括急性脊髓损伤时药物辅助治疗的应用。我们还将试图让读者对脊髓损伤和脊柱损伤的分类有基本的了解。最后，我们回顾脊柱稳定方面的进展，包括器械辅助融合和微创手术的改进。
