Engel-Haber Einat, Botticello Amanda, Snider Brittany, Kirshblum Steven
Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Kessler Foundation, West Orange, New Jersey, USA.
J Neurotrauma. 2022 Dec;39(23-24):1687-1696. doi: 10.1089/neu.2022.0196. Epub 2022 Jul 21.
The demographics of acute traumatic spinal cord injury (SCI) have changed over the last few decades, with a significant increase in age at the time of injury, a higher percentage of injuries caused by falls, and incomplete tetraplegia becoming the most common type of neurological impairment. Incomplete SCI syndromes, most specifically central cord syndrome (CCS), anterior cord syndrome (ACS) and Brown-Sequard syndrome (BSS), constitute a substantial proportion of incomplete tetraplegia and SCI overall. Nevertheless, the updated incidence of these syndromes is not well known, and their estimates vary considerably, largely because of methodological inconsistencies across previous studies. A retrospective analysis of individuals with new traumatic SCI enrolled in the Spinal Cord Injury Model Systems database between January 2011 and May 2020 was performed. Using newly proposed computable definitions for ACS and BSS, as well as an existing quantitative definition of CCS, we determined the current incidence and neurological characteristics of each syndrome. Within the population of individuals with a traumatic SCI, including all levels and severity of injuries (N = 3639), CCS, ACS, and BSS accounted for 14%, 6.5%, and 2%, respectively. Of the 1649 individuals with incomplete tetraplegia in our cohort, CCS was the most common syndrome (30%), followed by ACS (10%) and BSS (3%). Using quantifiable definitions, these three syndromes now account for ∼22% and ∼44% of cases of traumatic SCI and incomplete tetraplegia, respectively, with CCS having increased over the last decade. This updated information and proposed calculable criteria for these syndromes allow for a greater understanding of the incidence and characteristics of these syndromes and enable greater study in the future.
在过去几十年中，急性创伤性脊髓损伤（SCI）的人口统计学特征发生了变化，受伤时的年龄显著增加，因跌倒导致的损伤比例更高，不完全性四肢瘫成为最常见的神经功能障碍类型。不完全性SCI综合征，尤其是中央脊髓综合征（CCS）、脊髓前动脉综合征（ACS）和布朗 - 色夸综合征（BSS），在不完全性四肢瘫和总体SCI中占相当大的比例。然而，这些综合征的最新发病率并不为人所知，其估计值差异很大，主要是因为以往研究的方法不一致。对2011年1月至2020年5月期间纳入脊髓损伤模型系统数据库的新发创伤性SCI患者进行了回顾性分析。使用新提出的ACS和BSS的可计算定义，以及现有的CCS定量定义，我们确定了每种综合征的当前发病率和神经学特征。在创伤性SCI患者群体中，包括所有损伤水平和严重程度（N = 3639），CCS、ACS和BSS分别占14%、6.5%和2%。在我们队列中的1649例不完全性四肢瘫患者中，CCS是最常见的综合征（30%），其次是ACS（10%）和BSS（3%）。使用可量化的定义，这三种综合征现在分别占创伤性SCI病例的约22%和不完全性四肢瘫病例的约44%，CCS在过去十年中有所增加。这些关于这些综合征的最新信息和建议的可计算标准有助于更深入地了解这些综合征的发病率和特征，并为未来的研究提供更多便利。
