Alander D H, Parker J, Stauffer E S
Dickson-Diveley Midwest Orthopaedic Clinic, Kansas City, Missouri, USA.
Spine (Phila Pa 1976). 1997 Jun 1;22(11):1189-92. doi: 10.1097/00007632-199706010-00003.
This study retrospectively reviewed the intermediate-term clinical outcome of patients who were 50 years of age or older at the time they experienced their cervical spinal cord injury.
To establish reasonable expectations for the functional outcome in the older patient with cervical spinal cord injury.
The long-term morbidity and mortality of large groups of patients with spinal cord injury have been reported. The specific functional ability, disposition, morbidity, and mortality of this group of older patients injured after 50 years of age, however, have been less well defined.
Forty-one consecutive patients older than 50 years of age at the time of cervical cord injury were studied, and functional abilities, independence, need for assistance in activities of daily living, disposition, morbidity, and mortality were assessed. All patients had more than 2 years of follow-up examinations (mean, 5.5 years) by the same spine injury service.
There were 13 complete and 28 incomplete cervical cord lesions. The mean age of the patients at follow-up examination was 67.5 years. The average follow-up period was 5.5 years after injury. None of the patients with complete cord injury improved, and all required extensive care. Twenty-one (80%) of 26 of the patients with incomplete cord injury were able to ambulate with some assistance. Nineteen of 26 patients had independent or near-independent abilities with activities of daily living. Twenty (77%) of 26 were able to return home. All patients with complete cord injury (13 of 13) had died by the time of the follow-up visit. Seventy-seven percent (10 of 13) of this patient group had died within the first year. Those surviving lived an average of 3.5 years after their injury. Fourteen of 28 patients with incomplete cord injury (50%) had died by the time of the follow-up visit. Six (43%) of the 14 deaths were attributed to complications of their spinal cord injury.
The functional outcome of the person older than 50 years with a complete cervical cord injury is poor. Of the 14% who survived the first year, all required extensive attendant care, and no neurologic improvement was seen. The patient with an incomplete cord injury has an overall good outcome regarding ambulation and returning to home.
本研究回顾性分析了50岁及以上发生颈脊髓损伤患者的中期临床结局。
为老年颈脊髓损伤患者的功能结局建立合理预期。
已有大量脊髓损伤患者的长期发病率和死亡率的报道。然而，这组50岁以后受伤的老年患者的具体功能能力、生活安排、发病率和死亡率尚不明确。
对41例颈脊髓损伤时年龄超过50岁的连续患者进行研究，评估其功能能力、独立性、日常生活活动所需的协助、生活安排、发病率和死亡率。所有患者均由同一脊柱损伤服务机构进行了超过2年的随访检查（平均5.5年）。
有13例完全性和28例不完全性颈脊髓损伤。随访检查时患者的平均年龄为67.5岁。受伤后的平均随访期为5.5年。所有完全性脊髓损伤患者均无改善，且都需要广泛的护理。26例不完全性脊髓损伤患者中有21例（80%）在一定协助下能够行走。26例患者中有19例在日常生活活动方面具有独立或接近独立的能力。26例患者中有20例（77%）能够回家。所有完全性脊髓损伤患者（13例中的13例）在随访时均已死亡。该患者组中有77%（13例中的10例）在第一年内死亡。存活者受伤后平均存活3.5年。28例不完全性脊髓损伤患者中有14例（50%）在随访时已死亡。14例死亡患者中有6例（43%）归因于脊髓损伤并发症。
50岁以上的完全性颈脊髓损伤患者功能结局较差。在第一年存活下来的14%的患者中，所有人都需要广泛的护理照料，且未见神经功能改善。不完全性脊髓损伤患者在行走和回家方面总体结局良好。
