Siddall P J, Taylor D A, Cousins M J
Pain Management and Research Centre, University of Sydney, Royal North Shore Hospital, St Leonards, NSW, Australia.
Spinal Cord. 1997 Feb;35(2):69-75. doi: 10.1038/sj.sc.3100365.
Pain continues to be a significant management problem in people with spinal cord injuries. Despite this there is little consensus regarding the nature, terminology and definitions of the various types of pain that occur following spinal cord injury. This has led to large variations in the reported incidence and prevalence of pain following spinal cord injury. Treatment studies have been hampered by inconsistent and inaccurate identification of pain types. We believe that both research and management would benefit from an agreed upon classification system which accurately and reliably identifies the types of pain that occur following spinal cord injury. We have reviewed the literature on the classification of pain following spinal cord injury and have developed a classification system which adopts the strengths of previous systems and attempts to avoid the weakness inherent in others. Our proposed classification system of pain following spinal cord injury includes four major divisions: musculoskeletal, visceral, neuropathic and other types of pain. We have divided neuropathic pain on the basis of region into two subdivisions: neuropathic at level and neuropathic below level pain. We have further divided neuropathic at level pain into two categories: radicular and central, to indicate the presumed site of the lesion responsible for pain generation. We believe that our proposed classification system is comprehensive, simple and readily applicable in the clinical and research situation. It is our hope that this proposed classification will contribute to the eventual development of a universal system for the classification of pain following spinal cord injury.
疼痛仍然是脊髓损伤患者的一个重大管理难题。尽管如此，对于脊髓损伤后出现的各种疼痛的性质、术语和定义，几乎没有达成共识。这导致脊髓损伤后疼痛的报告发病率和患病率存在很大差异。治疗研究因疼痛类型的识别不一致和不准确而受到阻碍。我们认为，研究和管理都将受益于一个商定的分类系统，该系统能够准确、可靠地识别脊髓损伤后出现的疼痛类型。我们回顾了关于脊髓损伤后疼痛分类的文献，并开发了一个分类系统，该系统采用了先前系统的优点，并试图避免其他系统固有的弱点。我们提出的脊髓损伤后疼痛分类系统包括四个主要类别：肌肉骨骼性、内脏性、神经性和其他类型的疼痛。我们根据区域将神经性疼痛分为两个亚类：损伤平面处的神经性疼痛和损伤平面以下的神经性疼痛。我们进一步将损伤平面处的神经性疼痛分为两类：根性和中枢性，以表明假定的导致疼痛产生的病变部位。我们相信，我们提出的分类系统是全面、简单的，并且很容易应用于临床和研究情况。我们希望这个提议的分类将有助于最终开发一个通用的脊髓损伤后疼痛分类系统。
