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1806例创伤性脊髓损伤患者的流行病学特征:一项回顾性研究。

Epidemiological characteristics of 1,806 patients with traumatic spinal cord injury: A retrospective study.

作者信息

Wang Zhihua, Zhou Wu, Li Meihua

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.

出版信息

Front Surg. 2023 Jan 6;9:988853. doi: 10.3389/fsurg.2022.988853. eCollection 2022.

Abstract

BACKGROUND

Traumatic spinal cord injury (TSCI) is a type of highly disabling central nervous system trauma. In this study, we investigated the epidemiological characteristics of 1,806 TSCI patients and compared the characteristics of patients with traumatic cervical spinal cord injury (TCSCI) caused by cervical fracture/dislocation and disc herniation/bulging.

METHODS

We retrospectively reviewed the hospital records of 1,806 TSCI patients. The detailed information included gender, marital status, occupation, age, neurological level of injury, etiology, American Spinal Injury Association (ASIA) grade, combined injuries, complications, treatment, the interval between admission and surgery, intubation/tracheostomy requirement, and the length of hospital stay.

RESULTS

Cervical spinal cord injury (CSCI) was the most common injury. Compared to non-CSCI cases, patients with TCSCI were older, and more likely to suffer from tetraplegia and require intubation/tracheostomy, but had fewer other injuries or complications and a shorter length of hospital stay. Compared to patients with cervical fracture/dislocation, those with TCSCI caused by disc herniation/bulging were older and more likely to suffer from paraplegia, but required intubation/tracheostomy less frequently, exhibited fewer other injuries and complications, and required shorter hospitalization.

CONCLUSIONS

Men, married individuals, manual laborers, and individuals aged 31-75 years had the highest risk of TSCI. Patients with TCSCI tended to have a shorter length of hospital stay than patients with non-CSCI. More attention should be paid to the other injuries and complications of non-CSCI patients, which may increase the length of hospital stay and delay rehabilitation. Compared to patients with cervical disc herniation, the patients with fracture/dislocation tended to be younger, but prognosis was severely compromised by tetraplegia, a greater need for intubation/tracheostomy, additional injuries, and complications.

摘要

背景

创伤性脊髓损伤(TSCI)是一种导致高度残疾的中枢神经系统创伤。在本研究中,我们调查了1806例TSCI患者的流行病学特征,并比较了因颈椎骨折/脱位和椎间盘突出/膨出导致的创伤性颈脊髓损伤(TCSCI)患者的特征。

方法

我们回顾性分析了1806例TSCI患者的医院记录。详细信息包括性别、婚姻状况、职业、年龄、神经损伤平面、病因、美国脊髓损伤协会(ASIA)分级、合并伤、并发症、治疗、入院至手术间隔时间、插管/气管切开需求以及住院时间。

结果

颈脊髓损伤(CSCI)是最常见的损伤类型。与非CSCI病例相比,TCSCI患者年龄更大,更易发生四肢瘫且需要插管/气管切开,但其他损伤或并发症较少,住院时间较短。与颈椎骨折/脱位患者相比,因椎间盘突出/膨出导致TCSCI的患者年龄更大,更易发生截瘫,但插管/气管切开需求频率较低,其他损伤和并发症较少,住院时间较短。

结论

男性、已婚者、体力劳动者以及31 - 75岁的人群发生TSCI的风险最高。TCSCI患者的住院时间往往比非CSCI患者短。应更多关注非CSCI患者的其他损伤和并发症,这些可能会增加住院时间并延迟康复。与颈椎间盘突出患者相比,骨折/脱位患者往往更年轻,但四肢瘫、对插管/气管切开的更大需求、额外损伤和并发症严重影响了预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a404/9852498/2f431851393d/fsurg-09-988853-g001.jpg

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