Cremer Steven A, Maynard Frederick, Davidoff Gary
Department of Physical Medicine and Rehabilitation, University of Cincinnati School of Medicine, Cincinnati, OHU.S.A. Department of Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor, MIU.S.A. Rehabilitation Medicine Service, Veterans Administration Medical Center, Ann Arbor, MIU.S.A.
Pain. 1989 May;37(2):187-192. doi: 10.1016/0304-3959(89)90129-2.
Pain is a frequent problem following recent traumatic spinal cord injury (SCI). Of specific concern in the rehabilitation setting is function-limiting hand pain which prevents optimal participation in therapy and limits independence. A treatable etiology of function-limiting hand pain in SCI is the reflex sympathetic dystrophy syndrome (RSDS). The presentation of RSDS in patients with recent SCI can be easily confused with that of dysesthetic (central origin) or radicular pain. Previous reports of RSDS associated with recent traumatic SCI have not been based on specific clinical criteria outlined in recent literature, and treatment has not been evaluated by objective outcome measures. This report describes 5 cases of RSDS associated with recent traumatic SCI that are identified by specific clinical criteria and are confirmed by a 3 phase bone scan. It is suggested that aggressive early intervention is necessary to obtain optimal functional outcome and minimize length of hospital-based rehabilitation.
疼痛是近期创伤性脊髓损伤（SCI）后常见的问题。在康复环境中，特别值得关注的是限制功能的手部疼痛，它会妨碍患者充分参与治疗并限制其独立性。脊髓损伤中限制功能的手部疼痛的一个可治疗病因是反射性交感神经营养不良综合征（RSDS）。近期脊髓损伤患者中RSDS的表现很容易与感觉异常性（中枢性起源）或神经根性疼痛相混淆。先前关于近期创伤性脊髓损伤相关RSDS的报告并非基于近期文献中概述的特定临床标准，并且治疗也未通过客观结果指标进行评估。本报告描述了5例与近期创伤性脊髓损伤相关的RSDS病例，这些病例通过特定临床标准得以确诊，并经三相骨扫描证实。建议进行积极的早期干预，以获得最佳功能结果并尽量缩短住院康复时间。
