Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350000, China.
Department of Orthopedics, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350000, China.
J Orthop Surg Res. 2023 Nov 11;18(1):857. doi: 10.1186/s13018-023-04355-7.
Traumatic spinal cord injury (SCI) is a devastating neurological disorder often accompanied by neuropathic pain (NeP), significantly affecting patients' quality of life. This retrospective study aimed to investigate the impact of the time from injury to surgery on the development of NeP following traumatic SCI. Medical records of patients with traumatic SCI who underwent surgical intervention between January 2017 and January 2021 at two specialized centers were reviewed. Variables associated with NeP including demographics, injury profiles, medical history, surgical details, and pain assessments were investigated. Independent risk factors related to NeP were identified using multivariate logistic regression analysis. A total of 320 patients met the inclusion criteria, with 245 (76.6%) being male and a mean age of 56.5 ± 13.2 years. NeP was identified in 48.4% of patients (155 of 320). The multivariate analysis identifies age at injury, Injury Severity Score, and the neurological level of injury as independent risk factors for the development of NeP in both AIS A and AIS B, C, and D subgroups. Additionally, a significant association between the time from injury to surgery and NeP was observed in AIS B, C, and D patients, while no such association was found in AIS A patients. This study highlights the benefits of early and ultra-early surgical intervention in preventing NeP in patients with incomplete traumatic SCI (AIS B, C, and D), underscoring the importance of optimizing surgical timing to improve patient outcomes. Prospective studies are warranted to establish evidence-based surgical guidelines for managing traumatic SCI and preventing NeP effectively.
创伤性脊髓损伤 (SCI) 是一种严重的神经系统疾病，常伴有神经性疼痛 (NeP)，显著影响患者的生活质量。本回顾性研究旨在探讨创伤性 SCI 后手术时间对 NeP 发展的影响。对 2017 年 1 月至 2021 年 1 月在两个专业中心接受手术干预的创伤性 SCI 患者的病历进行了回顾。调查了与 NeP 相关的变量，包括人口统计学、损伤情况、病史、手术细节和疼痛评估。使用多变量逻辑回归分析确定与 NeP 相关的独立危险因素。共有 320 名患者符合纳入标准，其中 245 名 (76.6%)为男性，平均年龄为 56.5 ± 13.2 岁。320 名患者中有 155 名 (48.4%)出现 NeP。多变量分析确定损伤时的年龄、损伤严重程度评分和损伤的神经水平是 AIS A 和 AIS B、C 和 D 亚组中 NeP 发生的独立危险因素。此外，还观察到损伤至手术时间与 NeP 之间存在显著关联，在 AIS B、C 和 D 患者中，但在 AIS A 患者中未发现这种关联。这项研究强调了早期和超早期手术干预对预防不完全性创伤性 SCI (AIS B、C 和 D)患者 NeP 的益处，突出了优化手术时机以改善患者预后的重要性。需要进行前瞻性研究，以制定基于证据的创伤性 SCI 管理和有效预防 NeP 的手术指南。
