Berić A, Dimitrijević M R, Light J K
J Neurol Neurosurg Psychiatry. 1987 May;50(5):600-6. doi: 10.1136/jnnp.50.5.600.
Patients with spinal cord injury show upper motor neuron dysfunction below the level of the lesion. Some patients with cervical and high thoracic injuries show unexpected lower leg atrophy and ankle jerk abnormalities together with persistence of urinary retention. Clinical, neurophysiological and urodynamic findings in 130 patients with cervical and thoracic injuries showed that 18 patients had additional lumbosacral dysfunction. Three patients had radiological findings demonstrating a second lesion of the lower spine. The remaining 15 patients, however, did not have any obvious bony lesion to account for the lumbosacral dysfunction. Atypical neurological findings, abnormal neurophysiological testing and aberrant detrusor behaviour were the essence of the occult lumbosacral dysfunction in cervical and thoracic spinal cord injury patients. Recognition of the presence of a double lesion was important for care of the neuropathic bladder and pain in addition to understanding the unexpected clinical signs.
脊髓损伤患者在损伤平面以下表现出上运动神经元功能障碍。一些颈髓和高位胸髓损伤患者出现意外的小腿萎缩、踝关节反射异常以及持续性尿潴留。对130例颈髓和胸髓损伤患者的临床、神经生理学和尿动力学检查结果显示，18例患者存在额外的腰骶部功能障碍。3例患者的影像学检查发现下脊柱存在第二个损伤。然而，其余15例患者没有任何明显的骨质病变来解释腰骶部功能障碍。非典型神经学表现、异常神经生理学检测以及逼尿肌异常行为是颈髓和胸髓损伤患者隐匿性腰骶部功能障碍的关键所在。认识到双重损伤的存在对于神经源性膀胱的护理以及疼痛管理很重要，此外还有助于理解这些意外的临床体征。
