Traumatic Spinal Cord Injury (TSCI) remains a significant cause of human suffering. The World Health Organization estimates that there are between 250,000 to 500,000 new cases every year. Magnetic Resonance Imaging (M...Traumatic Spinal Cord Injury (TSCI) remains a significant cause of human suffering. The World Health Organization estimates that there are between 250,000 to 500,000 new cases every year. Magnetic Resonance Imaging (MRI) has been an important advancement in the diagnosis and management of TSCI. Nevertheless, there is a lack of literature correlating the radiological abnormalities and histopathological findings in the first hour (i.e., hyperacute period) after injury. The aim of this preliminary study is to elucidate the relationship between the MRI abnormalities and histopathological abnormalities in the hyperacute time period. In this study, a non-human primate model (NHP) primate model is used to characterize the histopathological and radiological features. Specifically, an experimental TSCI is created with an epidural catheter. This is followed by MRI imaging. The subject is then humanely euthanized and a post-mortem examination is completed. These results suggest that the noted radiological abnormalities are consistent with a combination of hemorrhage, edema as well as eosinophilic cellular matter in the central canal.展开更多
Pediatric and adult spinal cord injuries (SCI) are distinct entities.Children and adolescents with SCI must suffer from lifelong disabilities,which is a heavy burden on patients,their families and the society.There ar...Pediatric and adult spinal cord injuries (SCI) are distinct entities.Children and adolescents with SCI must suffer from lifelong disabilities,which is a heavy burden on patients,their families and the society.There are differences in Chinese and foreign literature reports on the incidence,injury mechanism and prognosis of SCI in children and adolescents.In addition to traumatic injuries such as car accidents and falls,the proportion of sports injuries is increasing.The most common sports injury is the backbend during dance practice.Compared with adults,children and adolescents are considered to have a greater potential for neurological improvement.The pathogenesis and treatment of pediatric SCI remains unclear.The mainstream view is that the mechanism of nerve damage in pediatric SCI include flexion,hyperextension,longitudinal distraction and ischemia.We also discuss the advantages and disadvantages of drugs such as methylprednisolone in the treatment of pediatric SCI and the indications and timing of surgery.In addition,the complications of pediatric SCI are also worthy of attention.New imaging techniques such as diffusion tensor imaging and diffusion tensor tractography may be used for diagnosis and assessment of prognosis.This article reviews the epidemiology,pathogenesis,imaging,clinical characteristics,treatment and complications of SCI in children and adolescents.Although current treatment cannot completely restore neurological function,patient quality of life can be enhanced.Continued developments and advances in the research of SCI may eventually provide a cure for children and adolescents with this kind of injury.展开更多
Purpose:The long-term situation of children with spinal cord injury(SCI)was investigated,and suggestions for helping them better return to the society were provided.Methods:SCI patients less than 18 years old hospital...Purpose:The long-term situation of children with spinal cord injury(SCI)was investigated,and suggestions for helping them better return to the society were provided.Methods:SCI patients less than 18 years old hospitalized in Beijing Boai Hospital from January 2011 to December 2020 were retrospectively analyzed.Information including motor function,complications,characteristic changes,self-care abilities,school attendance and social participation were collected by telephone interview and electronic questionnaire.All the answers were statistically analyzed.Results:A total of 86 cases were enrolled,77 girls and 9 boys,with a median injury age of 6 years and 2 months.The follow-up time was 3-130 months.The main cause of trauma in these children was sport injury(66.3%),the thoracic spinal cord was involved the most(91.9%),and complete SCIs accounted for the majority(76.7%).In terms of complications,children with complete SCIs were more likely to have urinary incontinence,constipation and characteristic changes(p<0.05);whereas the incomplete SCIs often have spasticity(p<0.05).As to the daily living abilities,children with incomplete lumbar SCIs were more capable to accomplish personal hygiene,transfer,and bathing independently than those with complete injuries,or cervical/thoracic SCIs,respectively(p<0.05).Moreover,children older than 9 years care more able to dress and transfer independently than the youngers(p<0.05).Wheelchair users accounted for 84.9%and more than half of them were able to propel wheelchair independently,and those who move passively in wheelchairs were mostly introverted kids(p<0.05).Almost all(93.8%)children with incomplete injuries were able to walk independently.Most(79.1%)children continued to attending school,and 41.9%participated in interest classes.Unfortunately,67.4%of the children spent less time playing with their peers than before the injury.Conclusion:SCIs impair physical structures and function of children,affect their independence in daily living,and restrict school attendance and social interaction.Comprehensive rehabilitation after injury is a systematic work.Medical staff and caregivers should not only pay attention to neurological function,but also help them improve self-care abilities.It is also important to balance rehabilitation training and school work and social participation.展开更多
目的:观察胸腰段脊髓损伤患者康复初期的肩部超声表现,分析肩关节异常超声表现的危险因素。方法:纳入2019年1月~2021年1月于我院康复医学科就诊的病程不超过3个月的胸腰段脊髓损伤患者104例进行研究,其中男78例,女26例,年龄37.3±8....目的:观察胸腰段脊髓损伤患者康复初期的肩部超声表现,分析肩关节异常超声表现的危险因素。方法:纳入2019年1月~2021年1月于我院康复医学科就诊的病程不超过3个月的胸腰段脊髓损伤患者104例进行研究,其中男78例,女26例,年龄37.3±8.8岁(21~66岁)。收集患者性别、体重、身高、损伤平面、日常生活能力(activities of daily living,ADL)评分、康复介入时间等基本资料,计算患者的体质指数(body mass index,BMI),对患者进行肩痛视觉模拟量表(visual analogue scale,VAS)评分、肩部体格检查(physical examination of the shoulder scale,PESS)评分和双侧肩关节超声检查。根据超声影像评估标准分为超声正常组和超声异常组。归纳分析肩关节超声异常表现的具体类型,对两组进行基本资料、肩痛VAS评分和PESS评分比较,将存在统计学差异的指标采用多因素Logistic回归分析,分析超声异常表现的危险因素。结果:70例(67.3%)患者超声检查显示肩关节异常,最常见的三种肩部超声异常表现为:肱二头肌长头肌腱腱鞘周围积液(62例,88.6%)、三角肌下滑囊增厚(53例,75.7%)和冈上肌腱异常(44例,62.9%)。超声异常组PESS评分为8.3±6.3分,超声正常组为1.2±2.1分,有统计学差异(P<0.05)。超声异常组年龄38.8±9.0岁,病程44.4±13.1d,超声正常组年龄34.1±7.3岁,病程37.9±11.3d,有统计学差异(P<0.05),两组患者性别、体重、BMI、损伤平面、肩痛VAS评分、ADL评分、康复介入时间均无统计学差异(P>0.05)。多因素Logistic回归分析显示,年龄和病程是超声异常表现的危险因素。结论:肱二头肌长头肌腱腱鞘周围积液、三角肌下滑囊增厚和冈上肌腱异常是胸腰段脊髓损伤患者康复初期最常见的三种肩部超声异常表现。年龄偏大、病程较长的患者易发生超声异常表现。展开更多
文摘Traumatic Spinal Cord Injury (TSCI) remains a significant cause of human suffering. The World Health Organization estimates that there are between 250,000 to 500,000 new cases every year. Magnetic Resonance Imaging (MRI) has been an important advancement in the diagnosis and management of TSCI. Nevertheless, there is a lack of literature correlating the radiological abnormalities and histopathological findings in the first hour (i.e., hyperacute period) after injury. The aim of this preliminary study is to elucidate the relationship between the MRI abnormalities and histopathological abnormalities in the hyperacute time period. In this study, a non-human primate model (NHP) primate model is used to characterize the histopathological and radiological features. Specifically, an experimental TSCI is created with an epidural catheter. This is followed by MRI imaging. The subject is then humanely euthanized and a post-mortem examination is completed. These results suggest that the noted radiological abnormalities are consistent with a combination of hemorrhage, edema as well as eosinophilic cellular matter in the central canal.
文摘Pediatric and adult spinal cord injuries (SCI) are distinct entities.Children and adolescents with SCI must suffer from lifelong disabilities,which is a heavy burden on patients,their families and the society.There are differences in Chinese and foreign literature reports on the incidence,injury mechanism and prognosis of SCI in children and adolescents.In addition to traumatic injuries such as car accidents and falls,the proportion of sports injuries is increasing.The most common sports injury is the backbend during dance practice.Compared with adults,children and adolescents are considered to have a greater potential for neurological improvement.The pathogenesis and treatment of pediatric SCI remains unclear.The mainstream view is that the mechanism of nerve damage in pediatric SCI include flexion,hyperextension,longitudinal distraction and ischemia.We also discuss the advantages and disadvantages of drugs such as methylprednisolone in the treatment of pediatric SCI and the indications and timing of surgery.In addition,the complications of pediatric SCI are also worthy of attention.New imaging techniques such as diffusion tensor imaging and diffusion tensor tractography may be used for diagnosis and assessment of prognosis.This article reviews the epidemiology,pathogenesis,imaging,clinical characteristics,treatment and complications of SCI in children and adolescents.Although current treatment cannot completely restore neurological function,patient quality of life can be enhanced.Continued developments and advances in the research of SCI may eventually provide a cure for children and adolescents with this kind of injury.
基金National Key R&D Program of China(grant no.2019YFB1312505)。
文摘Purpose:The long-term situation of children with spinal cord injury(SCI)was investigated,and suggestions for helping them better return to the society were provided.Methods:SCI patients less than 18 years old hospitalized in Beijing Boai Hospital from January 2011 to December 2020 were retrospectively analyzed.Information including motor function,complications,characteristic changes,self-care abilities,school attendance and social participation were collected by telephone interview and electronic questionnaire.All the answers were statistically analyzed.Results:A total of 86 cases were enrolled,77 girls and 9 boys,with a median injury age of 6 years and 2 months.The follow-up time was 3-130 months.The main cause of trauma in these children was sport injury(66.3%),the thoracic spinal cord was involved the most(91.9%),and complete SCIs accounted for the majority(76.7%).In terms of complications,children with complete SCIs were more likely to have urinary incontinence,constipation and characteristic changes(p<0.05);whereas the incomplete SCIs often have spasticity(p<0.05).As to the daily living abilities,children with incomplete lumbar SCIs were more capable to accomplish personal hygiene,transfer,and bathing independently than those with complete injuries,or cervical/thoracic SCIs,respectively(p<0.05).Moreover,children older than 9 years care more able to dress and transfer independently than the youngers(p<0.05).Wheelchair users accounted for 84.9%and more than half of them were able to propel wheelchair independently,and those who move passively in wheelchairs were mostly introverted kids(p<0.05).Almost all(93.8%)children with incomplete injuries were able to walk independently.Most(79.1%)children continued to attending school,and 41.9%participated in interest classes.Unfortunately,67.4%of the children spent less time playing with their peers than before the injury.Conclusion:SCIs impair physical structures and function of children,affect their independence in daily living,and restrict school attendance and social interaction.Comprehensive rehabilitation after injury is a systematic work.Medical staff and caregivers should not only pay attention to neurological function,but also help them improve self-care abilities.It is also important to balance rehabilitation training and school work and social participation.
文摘目的:观察胸腰段脊髓损伤患者康复初期的肩部超声表现,分析肩关节异常超声表现的危险因素。方法:纳入2019年1月~2021年1月于我院康复医学科就诊的病程不超过3个月的胸腰段脊髓损伤患者104例进行研究,其中男78例,女26例,年龄37.3±8.8岁(21~66岁)。收集患者性别、体重、身高、损伤平面、日常生活能力(activities of daily living,ADL)评分、康复介入时间等基本资料,计算患者的体质指数(body mass index,BMI),对患者进行肩痛视觉模拟量表(visual analogue scale,VAS)评分、肩部体格检查(physical examination of the shoulder scale,PESS)评分和双侧肩关节超声检查。根据超声影像评估标准分为超声正常组和超声异常组。归纳分析肩关节超声异常表现的具体类型,对两组进行基本资料、肩痛VAS评分和PESS评分比较,将存在统计学差异的指标采用多因素Logistic回归分析,分析超声异常表现的危险因素。结果:70例(67.3%)患者超声检查显示肩关节异常,最常见的三种肩部超声异常表现为:肱二头肌长头肌腱腱鞘周围积液(62例,88.6%)、三角肌下滑囊增厚(53例,75.7%)和冈上肌腱异常(44例,62.9%)。超声异常组PESS评分为8.3±6.3分,超声正常组为1.2±2.1分,有统计学差异(P<0.05)。超声异常组年龄38.8±9.0岁,病程44.4±13.1d,超声正常组年龄34.1±7.3岁,病程37.9±11.3d,有统计学差异(P<0.05),两组患者性别、体重、BMI、损伤平面、肩痛VAS评分、ADL评分、康复介入时间均无统计学差异(P>0.05)。多因素Logistic回归分析显示,年龄和病程是超声异常表现的危险因素。结论:肱二头肌长头肌腱腱鞘周围积液、三角肌下滑囊增厚和冈上肌腱异常是胸腰段脊髓损伤患者康复初期最常见的三种肩部超声异常表现。年龄偏大、病程较长的患者易发生超声异常表现。
