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慢性脊髓损伤

最后审阅: 5 Oct 2024
最后更新: 07 Sep 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 运动无力
  • 精细运动协调能力丧失
  • 痉挛状态
  • 感觉异常、麻木、感觉不良
  • 反射亢进和踝阵挛
  • 病理反射
  • 挛缩
  • 肛周感觉、自主肛门挛缩和肛门张力丧失
  • 自主神经反射障碍
  • 脊髓空洞
完整详情

其他诊断因素

  • 中枢(中线)疼痛
  • 束带样痛
  • 肌肉骨骼或内脏疼痛
  • 步态不稳
  • 尿失禁或尿潴留
  • 便秘
  • 性功能障碍
  • 非特异性不适感
  • 神经根疼痛
完整详情

危险因素

  • 脊髓外伤或缺血
  • 高节段脊髓损伤
  • 两端年龄
  • 椎管狭窄
  • 男性
完整详情

诊断性检查

需考虑的检查

  • 脊柱 MRI 检查
  • 肌电图 (EMG)
  • 尿动力学研究
  • 膀胱超声检查
  • 肾脏超声
  • 排泄性尿路造影
  • 骨密度测定(DEXA)
  • 实验室评估
完整详情

治疗流程

急症处理

进行性神经功能障碍

神经状态稳定

撰稿人

作者

Cristina Sadowsky, MD

Clinical Director

International Center for Spinal Cord Injury

Kennedy Krieger Institute

Associate Professor Physical Medicine and Rehabilitation

Johns Hopkins School of Medicine

Baltimore

MD

利益声明

CS is an author of a number of references cited in this topic.

Travis Edmiston, MD

Assistant Professor for Physical Medicine and Rehabilitation

International Center for Spinal Cord Injury

Kennedy Krieger Institute

Baltimore

MD

利益声明

TE declares that he has no competing interests.

鸣谢

Dr Cristina Sadowsky and Dr Travis Edmiston would like to gratefully acknowledge Dr Kenneth Casey and Dr Jwalant Mehta, previous contributors to this topic.

利益声明

KC and JM declare that they have no competing interests.

同行评议者

Steven Kirshblum, MD

Medical Director and Director of Spinal Cord Injury Services

Kessler Institute for Rehabilitation

West Orange

Professor

University of Medicine and Dentistry of New Jersey/New Jersey Medical School

Newark

NJ

利益声明

SK declares that he has no competing interests.

Deborah Short, MRCP

Consultant in Rehabilitation Medicine

Robert Jones and Agnes Hunt Hospital

Oswestry

UK

利益声明

DS declares that she has no competing interests.

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