Levi R, Hultling C, Seiger A
Solberga SCI Research Project, Huddinge University Hospital, Stockholm, Sweden.
Paraplegia. 1995 Oct;33(10):585-94. doi: 10.1038/sc.1995.125.
The Stockholm Spinal Cord Injury Study (SSCIS) is an extensive evaluation of a sample of 353 subjects with traumatic SCI, constituting 93% of the known regional prevalence population with this diagnosis. In a previous analysis of this group, symptoms such as pain, incontinence, sexual dysfunction and neurological deterioration, as well as secondary complications, such as decubitus ulcers, urinary tract infections, spinal deformity and fractures, were found to be common. In the present report, we investigate associations between a few commonly used patient characteristics, ie gender, age at injury, duration of injury and extent of neurological compromise, and the occurrence of such problems, to assess differences in vulnerability in SCI subgroups. Results generally indicate an increased vulnerability in subjects with extensive neurological deficits, as well as a cumulation of complications with the increasing duration of injury. However, some exceptions are found, possibly indicating differences in temporal patterns of the occurrence of various complications, as well as certain gender-, age-, and lesion-associated variations in vulnerability. Symptoms directly related to the spinal cord lesion, eg neurogenic pain and neurological deterioration, seem to present rather soon post-injury. Males are more prone to experience excessive spasticity and sexual problems. Females experience more fractures and spinal deformity. Younger age at injury is associated with more spinal deformity but less severe pain problems. Higher age at injury is not found to be associated with more medical problems, with the exception of neurogenic pain, among post-acute, post-discharge survivors. The latter finding does not, however, preclude more such problems in the acute stage, since the present study neither addresses the pre-discharge period, nor includes information about mortality. Finally, the ASIA/IMSOP Impairment Scale Grade E-rated subjects were found to report problems to an extent that underlines the restricted sensorimotor sense in which this rating reflects recovery.
斯德哥尔摩脊髓损伤研究（SSCIS）对353名创伤性脊髓损伤患者样本进行了全面评估，这些患者占该诊断已知区域患病率人群的93%。在对该组患者的先前分析中，发现疼痛、失禁、性功能障碍和神经功能恶化等症状以及褥疮、尿路感染、脊柱畸形和骨折等继发性并发症很常见。在本报告中，我们研究了一些常用的患者特征（即性别、受伤年龄、受伤持续时间和神经功能损害程度）与这些问题发生之间的关联，以评估脊髓损伤亚组中易感性的差异。结果总体表明，神经功能缺损广泛的患者易感性增加，并且并发症随着受伤持续时间的增加而累积。然而，也发现了一些例外情况，这可能表明各种并发症发生的时间模式存在差异，以及在易感性方面存在某些与性别、年龄和损伤相关的变化。与脊髓损伤直接相关的症状，如神经源性疼痛和神经功能恶化，似乎在受伤后很快就会出现。男性更容易出现过度痉挛和性问题。女性则更容易发生骨折和脊柱畸形。受伤时年龄较小与更多的脊柱畸形相关，但疼痛问题较轻。除了神经源性疼痛外，在急性后期、出院后的幸存者中，未发现受伤时年龄较大与更多的医疗问题相关。然而，后一项发现并不排除在急性期有更多此类问题，因为本研究既未涉及出院前阶段，也未包括有关死亡率的信息。最后，发现亚洲脊髓损伤学会/国际脊髓损伤神经分类标准E级评定的受试者报告的问题程度突出了该评定所反映的恢复中受限的感觉运动功能。
