Hoyen H Alex, Li Sean, Miller Michael, Joseph Sheeba, Getty Patrick, Lombardo Lisa, Pinault Gilles, Triolo Ronald
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
Case Western Reserve University School of Medicine, Cleveland, OH.
Arch Rehabil Res Clin Transl. 2025 Mar 13;7(2):100448. doi: 10.1016/j.arrct.2025.100448. eCollection 2025 Jun.
To assess whether lower extremity degenerative joint changes developed in long-term users of implantable neuromuscular prostheses.
Before-after radiographic assessment.
Tertiary care center.
Four individuals (4 men, average age 46.5y, injuries ranging from C7-T11) with spinal cord injury resulting in lower extremity paraplegia were included for analysis. All individuals previously received surgery for the placement of a neuroprosthesis implant system. Individuals were followed with specific spinal cord injury outcome measures and radiographs in a prospective manner. Individual implant usage was also recorded as part of the standard treatment. These individuals were selected because they were in the highest tier for daily use of the implant system.
Not applicable.
Development of degenerative joint pathology, based on analysis of pre- and post-therapy radiographs and grading using the Kellgren and Lawrence and Van Dijk scales.
None of the joints for the individuals that were graded 0-2 (no or mild arthritis) progressed to a grade 3 (moderate arthritis). Further, none of the joints developed an arthritic grade of >3. Only 2 of the 24 total joints had statistically significant (<.05) degenerative changes: subject 1: right hip; =.033 (average grade increased from 0.875-1.875); subject 2: right hip; =.049 (average grade increased from 0.875-1.50).
At an average of 5 years after implantation, regular and independent weight bearing in 4 higher-than-average users of a neuromuscular prosthesis does not appear to promote lower extremity joint degeneration.
评估长期使用植入式神经肌肉假体的患者是否会出现下肢退行性关节改变。
前后影像学评估。
三级医疗中心。
纳入4例因脊髓损伤导致下肢截瘫的患者（4名男性，平均年龄46.5岁，损伤范围为C7 - T11）进行分析。所有患者此前均接受了神经假体植入系统的手术。对患者进行前瞻性随访，采用特定的脊髓损伤结局指标和X光片检查。个人植入物的使用情况也作为标准治疗的一部分进行记录。选择这些患者是因为他们在植入系统的日常使用量处于最高水平。
不适用。
根据治疗前后X光片分析及使用凯尔格伦和劳伦斯以及范迪克量表进行分级，评估退行性关节病变的发展情况。
评分为0 - 2级（无或轻度关节炎）的患者关节均未进展至3级（中度关节炎）。此外，所有关节均未发展为关节炎等级>3级。在总共24个关节中，只有2个关节有统计学意义（<.05）的退行性改变：受试者1：右髋；P = 0.033（平均等级从0.875增加到1.875）；受试者2：右髋；P = 0.049（平均等级从0.875增加到1.50）。
在植入后平均5年时，4名高于平均使用量的神经肌肉假体使用者进行规律且独立的负重活动，似乎并不会促进下肢关节退变。
