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创伤性脊髓损伤患者颈椎融合长度与功能预后的相关性——一项基于注册登记的队列研究

The Correlation between Cervical Fusion Length and Functional Outcomes in Patients with Traumatic Spinal Cord Damage-A Registry-Based Cohort Study.

作者信息

Rau Yannick, Thietje Roland, Schulz Arndt-Peter, Auerswald Marc, Böthig Ralf, Hirschfeld Sven

机构信息

Faculty of Medicine, Universität zu Lübeck, 23562 Lübeck, Germany.

Spinal-Cord-Injury Center, BG Klinikum Hamburg, 21033 Hamburg, Germany.

出版信息

J Clin Med. 2022 Oct 4;11(19):5867. doi: 10.3390/jcm11195867.

DOI:10.3390/jcm11195867
PMID:36233733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9570914/
Abstract

This study aims to assess if there is an evident correlation between fusion length and rehabilitation success after trauma to the cervical spine that could potentially be used to predict functional outcomes. This monocentric study was conducted in the Spinal-Cord-Injury center of the Berufsgenossenschaftliches Klinikum Hamburg. Data sets of 199 patients from the Spinal-Cord-Injury center admitted between the beginning of 2003 and the end of 2018 were subjected to statistical analyses. The Spinal Cord Independence Measure II (SCIM II) difference between admission and discharge was chosen as the primary outcome variable of a multiple linear regression analysis, including several other variables. The length of fusion, SCIM at admission and the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) values at admission could be identified as significant predictors. The cervical fusion length could be identified as an independent predictor of the functional outcome within our model. This correlation most likely mediates for the range of motion as well as partly for injury severity. This is much harder to evaluate in a newly admitted rehabilitation patient than a single numerical value that represents its rehabilitative implications, such as fusion length. Together with an initial assessment of the SCIM and ISNCSCI, it provides a solid basis for outcome prediction.

摘要

本研究旨在评估颈椎创伤后融合长度与康复成功之间是否存在明显关联,这种关联有可能用于预测功能结局。这项单中心研究在汉堡职业协会医院的脊髓损伤中心开展。对2003年初至2018年底收治于该脊髓损伤中心的199例患者的数据集进行了统计分析。选取入院时与出院时脊髓独立功能评定量表第二版(SCIM II)的差值作为多元线性回归分析的主要结局变量,该分析还纳入了其他几个变量。融合长度、入院时的SCIM以及入院时的脊髓损伤神经学分类国际标准(ISNCSCI)值可被确定为显著预测因素。在我们的模型中,颈椎融合长度可被确定为功能结局的独立预测因素。这种关联很可能对活动范围以及部分损伤严重程度起到中介作用。相较于代表康复意义的单一数值(如融合长度),在新入院的康复患者中评估这一点要困难得多。结合对SCIM和ISNCSCI的初始评估,它为结局预测提供了坚实的基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3802/9570914/16a8d0f8a450/jcm-11-05867-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3802/9570914/9c3ed9170902/jcm-11-05867-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3802/9570914/16a8d0f8a450/jcm-11-05867-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3802/9570914/9c3ed9170902/jcm-11-05867-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3802/9570914/16a8d0f8a450/jcm-11-05867-g002.jpg

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World Neurosurg. 2019 Sep;129:e485-e493. doi: 10.1016/j.wneu.2019.05.188. Epub 2019 May 29.
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