Bittar Cíntia Kelly, Perucci Isabela Ferreira, Signorini Danillo Nagel, Mascarenhas Mariana Buratti, Silvestre Orcizo Francisco, Cliquet Alberto
Pontifícia Universidade Católica de Campinas, School of Medical Sciences, Campinas, SP, Brazil.
Universidade Estadual de Campinas, Department of Orthopedics, Rheumatology and Traumatology, Campinas, SP, Brazil.
Acta Ortop Bras. 2024 Mar 22;32(1):e264175. doi: 10.1590/1413-785220243201e264175. eCollection 2024.
The inability of the spinal cord to propagate sensory and motor stimuli as a result of the disruption of the nerve tracts is called spinal cord injury.
This study analyzes clinically and radiologically the hands and wrists of spinal cord injured patients, evaluating their motor and sensitive functionality, in order to determine if these patients are more likely to develop degenerative alterations.
14 patients (8 paraplegics and 6 tetraplegics) were evaluated, undergoing anamnesis and clinical examination - a scale of muscular strength (MRC - Medical Research Council) and the amplitude measurement of the movement with a manual goniometer (ROM), were used for objective evaluation - and x-ray exams. The results were compared with pre-existing data from other studies.
When asked, only one of the 14 observed patients complained about constant wrist pain, described as level 3 (weak to moderate), based on the visual analog scale (VAS). The motor evaluation, MRC and ROM divided the group of patients into two subgroups: paraplegic and tetraplegic patients. The x-ray analysis showed, based on Kellgren and Lawrence classification, that all exam images fit grades 1 or 2 of osteoarthritis and osteoarthrosis.
In conclusion, spinal cord injured patients showed none or minimal clinical and radiological signs of osteoarthritis on hands or wrists. Overall, the hands and wrists of spinal cord-injured patients behave similarly to noninjured patients. .
由于神经束中断导致脊髓无法传导感觉和运动刺激,这种情况被称为脊髓损伤。
本研究对脊髓损伤患者的手部和腕部进行临床和放射学分析,评估其运动和感觉功能,以确定这些患者是否更易发生退行性改变。
对14例患者(8例截瘫患者和6例四肢瘫患者)进行评估,进行问诊和临床检查——使用肌肉力量量表(医学研究委员会MRC)和手动角度计测量运动幅度(ROM)进行客观评估——并进行X线检查。将结果与其他研究的现有数据进行比较。
在被询问时,14例观察患者中只有1例抱怨手腕持续疼痛,根据视觉模拟量表(VAS),疼痛程度为3级(轻度至中度)。运动评估、MRC和ROM将患者分为两个亚组:截瘫患者和四肢瘫患者。根据凯尔格伦和劳伦斯分类法进行的X线分析显示,所有检查图像均符合骨关节炎和骨关节病的1级或2级。
总之,脊髓损伤患者手部或腕部未显示或仅有极少的骨关节炎临床和放射学迹象。总体而言,脊髓损伤患者的手部和腕部表现与未受伤患者相似。