Perlow D L, Diokno A C
Urology. 1981 Nov;18(5):531-5. doi: 10.1016/0090-4295(81)90314-9.
The results of combined cystometry and perineal electromyography were reviewed retrospectively in 75 consecutive, traumatic spinal cord-injured patients to predict lower urinary tract dysfunctions. In patients with vertebral spinal injuries at vertebral level T7 or above a reflex neurogenic bladder eventually developed. In those with vertebral level injuries T11 or below a lower motor neuron bladder dysfunction developed. Injuries at the vertebral levels T8, T9, and T10 represent a gray zone; and, depending on adjacent soft tissue injury, in these patients an upper or lower motor neuron bladder dysfunction developed. In transition from spinal shock (areflexia) to reflex neurogenic (hyperreflexia) bladder occurred at different times in different patients and could not be correlated to level of injury or its severity. The periurethral striated muscle was generally denervated if a lower motor neuron bladder dysfunction existed, however, rarely, dissociation may occur. When a reflex neurogenic bladder existed, sphincter dyssynergia was present 68 per cent of the time. This also could not be correlated with time after injury, level of injury, or severity of injury.
回顾性分析了75例连续性创伤性脊髓损伤患者的膀胱测压和会阴肌电图联合检查结果，以预测下尿路功能障碍。在T7或以上椎体水平发生脊柱损伤的患者最终会发展为反射性神经源性膀胱。在T11或以下椎体水平损伤的患者中，会出现下运动神经元性膀胱功能障碍。T8、T9和T10椎体水平的损伤代表一个灰色区域；并且，根据相邻软组织损伤情况，这些患者会出现上运动神经元或下运动神经元性膀胱功能障碍。从脊髓休克（无反射）到反射性神经源性（反射亢进）膀胱的转变在不同患者中发生的时间不同，且与损伤水平或严重程度无关。如果存在下运动神经元性膀胱功能障碍，尿道周围横纹肌通常会失神经支配，然而，很少会出现分离现象。当存在反射性神经源性膀胱时，68%的时间会出现括约肌协同失调。这也与受伤时间、损伤水平或损伤严重程度无关。
