MOTOR RECOVERY OF PATIENTS PRESENTING WITH MOTOR PARALYSIS AND SENSORY SPARING FOLLOWING CERVICAL SPINAL-CORD INJURIES

被引：51

作者：

KATOH, S

ELMASRY, WS

机构：

[1] The Midlands Centre for Spinal Injuries, The Robert Jones and Agnes Hunt Orthopaedic, District Hospital, Oswestry, Shropshire

来源：

PARAPLEGIA | 1995年 / 33卷 / 09期

关键词：

SPINAL CORD INJURY; CERVICAL VERTEBRAE; PARALYSIS; NEUROLOGICAL RECOVERY;

D O I：

10.1038/sc.1995.110

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

We studied the neurological progress of 21 consecutive patients with cervical spinal cord injuries, presenting with sensory sparing but with complete motor paralysis below the level of their injury (Frankel B). All patients were admitted within 48 h of injury and treated conservatively with 6 weeks of bedrest and traction, followed by 6 weeks of bracing. The follow-up period was more than 1 year (49.6 months on average). Despite the initial absence of motor power in the lower limbs, seven patients recovered significant motor power and were able to walk. The preservation of pinprick sensation between the level of the injury and the sacral dermatomes was the best prognostic indicator for useful motor recovery with 75% of the patients regaining the ability to walk. This pattern of sensory sparing predicted a statistically significant better motor outcome than other patterns of sensory sparing. Although 50% of patients with no sacral sensation and/or with anal sensation on rectal examination recovered motor power, this recovery was functional in only one out of eight patients.

引用

页码：506 / 509

页数：4

共 13 条

[1]

Frankel H.L., Et al., The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Part I, Paraplegia, 7, pp. 179-192, (1969)

[2]

Stauffer E.S., Diagnosis and prognosis of acute cervical spinal cord injury, Clin Orthop, 112, pp. 9-15, (1975)

[3]

Bosch A., Stauffer E.S., Nickel V.L., Incomplete traumatic quadri- plegia. A ten-year review, JAMA, 216, pp. 473-478, (1971)

[4]

El Masri W.S., Jaffray D., Recent developments in the management of injuries of the cervical spine, Handbook of Clinical Neurology, 17, 61, pp. 55-73

[5]

Waters R.L., Adkins R.H., Yakura J.S., Sie I., Motor and sensory recovery following incomplete tetraplegia, Arch Phys Med Re- Habil, 75, pp. 306-311, (1994)

[6]

Anderson P.A., Bohlman H.H., Anterior decompression and arthrodesis of the cervical spine: Long-term motor improvement. Part II—Improvement in complete traumatic quadri- plegia, J Bone Joint Surg Am, 74, pp. 683-692

[7]

Foo D., Subrahmanyan T.S., Rossier A.B., Post-traumatic acute anterior spinal cord syndrome, Paraplegia, 19, pp. 201-205, (1981)

[8]

Folman Y., El Masri W., Spinal cord injury: Prognostic indicators, Injury, 20, pp. 92-93, (1989)

[9]

Crozier K.SV., Graziani S.V., Ditunno J.F., Herbison G.J., Spinal cord injury: Prognosis for ambulation based on sensory examination in patients who are initially motor complete, Arch Phys Med Rehabil, 72, pp. 119-121, (1991)

[10]

Ditunno J.F., Young W., Donovan W.H., Creasey G., The international standards booklet for neurological and functional classification of spinal cord injury, Paraplegia, 32, pp. 70-80, (1994)

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