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伴有脊髓神经失用和短暂性四肢瘫的颈椎管狭窄症

Cervical spinal stenosis with cord neurapraxia and transient quadriplegia.

作者信息

Torg J S

机构信息

Hahnemann University, Sports Medicine Center, Philadelphia, USA.

出版信息

Sports Med. 1995 Dec;20(6):429-34. doi: 10.2165/00007256-199520060-00007.

Abstract

Cervical cord neurapraxia is a transient, totally reversible phenomenon that results from compressive deformation of the spinal cord. It occurs as a result of developmental narrowing of the cervical canal, either as isolated entity or in combination with degenerative changes, instability or congenital abnormalities. Uncomplicated stenosis of the cervical canal in an individual with a stable spine does not predispose to permanent neurological injury. Our data does not indicate a correlation between developmental narrowing and permanent neurological sequelae in a spine rendered unstable by football-induced trauma. However, there are data indicating that the occurrence of an episode of cervical cord neurapraxia is not a harbinger, or an indication of susceptibility to permanent neurological sequelae. Nevertheless, we recommended that continued participation in collision activities be restricted in individuals who have a documented episode of cervical cord neurapraxia associated with (i) ligamentous instability; (ii) intervertebral disc disease with cord compression; (iii) significant degenerative changes; (iv) magnetic resonance imaging evidence of cord defect or swelling; (v) symptoms of positive neurological findings lasting more than 36 hours; and (vi) more than one recurrence.

摘要

颈髓神经失用症是一种短暂的、完全可逆的现象,由脊髓的压缩性变形引起。它是由于颈椎管发育性狭窄导致的,可单独出现,也可与退行性改变、不稳定或先天性异常同时存在。脊柱稳定的个体出现单纯的颈椎管狭窄不会导致永久性神经损伤。我们的数据并未表明在因足球运动导致的创伤而变得不稳定的脊柱中,发育性狭窄与永久性神经后遗症之间存在相关性。然而,有数据表明,颈髓神经失用症发作并非永久性神经后遗症的先兆或易感性指标。尽管如此,我们建议,对于有记录的与以下情况相关的颈髓神经失用症发作的个体,应限制其继续参与碰撞活动:(i)韧带不稳定;(ii)伴有脊髓压迫的椎间盘疾病;(iii)明显的退行性改变;(iv)磁共振成像显示脊髓有缺陷或肿胀;(v)阳性神经学检查结果的症状持续超过36小时;以及(vi)发作不止一次。

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