Vlahovitch B, Fuentes J M, Choucair Y, Verger A C
Neurochirurgie. 1977 Mar 15;23(1):55-72.
In severe spinal cord trauma with initial complete paraplegia or tetraplegia, even the smallest recovery of sensibility to pain or motor function has an obvious prognostical value as it results from the study of 112 spinal injuries. For the motor aspect it is well known from experimental work and in man that even a small part of a single pyramidal tract in the spinal cord can take in charge the bilateral motricity of the limbs. It remains exceptional in severe spinal cord injury that recovery of motricity is not followed by a return of pain sens. In the lateral funiculus of the cord the sensitive and pyramidal tracts belongs to a same anastomotic vascular area between the central and peripherical circulatory streams. In physiological conditions this intermediate circulatory stream is poorly functional. But in severe spinal cord trauma with reduction of central blood flow the adjacent spinothalamic and corticospinal tracts survive in couple on the basis of the same anastomotic vascular area: from this results the prognostical unity that belongs to pain sens and motricity.
在伴有初始完全性截瘫或四肢瘫的严重脊髓损伤中，根据对112例脊髓损伤的研究，即使对疼痛的感觉或运动功能有最轻微的恢复也具有明显的预后价值。就运动方面而言，从实验研究以及人体研究中可知，脊髓中哪怕单一锥体束的一小部分也可负责双侧肢体的运动。在严重脊髓损伤中，运动功能恢复后疼痛感觉未恢复的情况仍属罕见。在脊髓侧索中，感觉束和锥体束属于中央和外周循环血流之间的同一个吻合血管区域。在生理状态下，这个中间循环血流功能欠佳。但在伴有中央血流减少的严重脊髓损伤中，相邻的脊髓丘脑束和皮质脊髓束基于同一个吻合血管区域而共同存活：由此得出疼痛感觉和运动功能预后的一致性。
