Pikija Slaven, Kunz Alexander B, Nardone Raffaele, Enzinger Christian, Pfaff Johannes A R, Trinka Eugen, Seifert-Held Thomas, Sellner Johann
Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, Salzburg, Austria.
Ther Adv Neurol Disord. 2022 Mar 11;15:17562864221076321. doi: 10.1177/17562864221076321. eCollection 2022.
Spinal cord infarction (SCI) is a neurological emergency associated with high rates of persistent neurological deficits. Knowledge about this rare but potentially treatable condition needs to be expanded.
To describe the characteristics of spontaneous SCI in a large retrospective series of patients treated at two tertiary care centers in Austria.
We performed a descriptive and comparative analysis of spontaneous SCI treated at the University Hospitals of Salzburg and Graz between the years 2000 and 2020. The analysis included pre- and in-hospital procedures, clinical presentation, etiology, diagnostic certainty, reperfusion therapy, and functional outcome at discharge.
We identified 88 cases, 61% were ascertained in the second half of the study period. The median age was 65.5 years [interquartile range (IQR) = 56-74], 51.1% were women. Anterior spinal artery infarction was the predominant syndrome (82.9%). Demographics, vascular comorbidities, and clinical presentation did not differ between the centers. The most frequent etiology and level of diagnostic certainty were distinct, with atherosclerosis (50%) and definite SCI (42%), and unknown (52.5%) and probable SCI (60%) as front runners in Salzburg and Graz, respectively. Patients arrived after a median of 258.5 min (IQR = 110-528) at the emergency room. The first magnetic resonance imaging (MRI) of the spinal cord was performed after a median of 148 min (IQR = 90-312) from admission and was diagnostic for SCI in 45%. Two patients received intravenous thrombolysis (2.2%). The outcome was poor in 37/77 (48%).
Demographics, clinical syndromes, and quality benchmarks for spontaneous SCI were consistent at two Austrian tertiary care centers. Our findings provide the foundation for establishing standards for pre- and in-hospital care to improve outcomes.
脊髓梗死（SCI）是一种神经急症，常伴有持续性神经功能缺损。对于这种罕见但可能可治疗的疾病，相关知识有待拓展。
描述在奥地利两个三级医疗中心接受治疗的大量回顾性系列患者中自发性脊髓梗死的特征。
我们对2000年至2020年间在萨尔茨堡和格拉茨大学医院治疗的自发性脊髓梗死进行了描述性和比较性分析。分析内容包括院前和院内程序、临床表现、病因、诊断确定性、再灌注治疗以及出院时的功能结局。
我们确定了88例病例，61%是在研究期后半段确诊的。中位年龄为65.5岁[四分位间距（IQR）=56 - 74]，51.1%为女性。脊髓前动脉梗死是主要综合征（82.9%）。两个中心在人口统计学、血管合并症和临床表现方面无差异。最常见的病因和诊断确定性水平各不相同，在萨尔茨堡，动脉粥样硬化（50%）和明确的脊髓梗死（42%）最为常见，而在格拉茨，病因不明（52.5%）和可能的脊髓梗死（60%）最为常见。患者到达急诊室的中位时间为258.5分钟（IQR = 110 - 528）。入院后中位148分钟（IQR = 90 - 312）进行了首次脊髓磁共振成像（MRI），其中45%诊断为脊髓梗死。两名患者接受了静脉溶栓治疗（2.2%）。77例患者中有37例（48%）预后较差。
奥地利两个三级医疗中心自发性脊髓梗死的人口统计学、临床综合征和质量基准是一致的。我们的研究结果为制定院前和院内护理标准以改善结局奠定了基础。
