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儿童和青少年脊髓损伤的临床特点和治疗。

Clinical characteristics and treatment of spinal cord injury in children and adolescents.

机构信息

Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning Province, China.

Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian, 116000, Liaoning Province, China; Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian, 116000, Liaoning Province, China.

出版信息

Chin J Traumatol. 2023 Jan;26(1):8-13. doi: 10.1016/j.cjtee.2022.04.007. Epub 2022 Apr 16.

Abstract

Pediatric and adult spinal cord injuries (SCI) are distinct entities. Children and adolescents with SCI must suffer from lifelong disabilities, which is a heavy burden on patients, their families and the society. There are differences in Chinese and foreign literature reports on the incidence, injury mechanism and prognosis of SCI in children and adolescents. In addition to traumatic injuries such as car accidents and falls, the proportion of sports injuries is increasing. The most common sports injury is the backbend during dance practice. Compared with adults, children and adolescents are considered to have a greater potential for neurological improvement. The pathogenesis and treatment of pediatric SCI remains unclear. The mainstream view is that the mechanism of nerve damage in pediatric SCI include flexion, hyperextension, longitudinal distraction and ischemia. We also discuss the advantages and disadvantages of drugs such as methylprednisolone in the treatment of pediatric SCI and the indications and timing of surgery. In addition, the complications of pediatric SCI are also worthy of attention. New imaging techniques such as diffusion tensor imaging and diffusion tensor tractography may be used for diagnosis and assessment of prognosis. This article reviews the epidemiology, pathogenesis, imaging, clinical characteristics, treatment and complications of SCI in children and adolescents. Although current treatment cannot completely restore neurological function, patient quality of life can be enhanced. Continued developments and advances in the research of SCI may eventually provide a cure for children and adolescents with this kind of injury.

摘要

小儿和成人脊髓损伤(SCI)是两种不同的疾病。患有 SCI 的儿童和青少年必须终生残疾,这对患者、他们的家庭和社会都是沉重的负担。中外文献对儿童和青少年 SCI 的发病率、损伤机制和预后的报道存在差异。除了车祸和跌倒等创伤性损伤外,运动损伤的比例也在增加。最常见的运动损伤是舞蹈练习中的后弯。与成年人相比,儿童和青少年被认为具有更大的神经改善潜力。小儿 SCI 的发病机制和治疗仍不清楚。主流观点认为,小儿 SCI 神经损伤的机制包括屈曲、过伸、纵向分离和缺血。我们还讨论了甲基强的松龙等药物在小儿 SCI 治疗中的优缺点以及手术的适应证和时机。此外,小儿 SCI 的并发症也值得关注。扩散张量成像和扩散张量纤维束成像等新的成像技术可能用于诊断和评估预后。本文综述了小儿 SCI 的流行病学、发病机制、影像学、临床特征、治疗和并发症。尽管目前的治疗方法不能完全恢复神经功能,但可以提高患者的生活质量。对 SCI 的研究的不断发展和进步最终可能为这种损伤的儿童和青少年提供治愈方法。

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