慢性脊髓损伤

最后审阅: 1 六月 2022
最后更新: 04 十二月 2018

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
  • 精细运动协调功能丧失
  • 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
更多 关键诊断因素

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
其他诊断因素

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
更多 危险因素

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
  • 排泄性尿路造影
更多 需考虑的检查

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

Kenneth Casey, MD, FACS

Clinical Associate Professor of Surgery (Neurosurgery)

Michigan State University School of Medicine

Clinical Associate Professor of Physical Medicine and Rehabilitation

Wayne State University School of Medicine

Surgical Director Intensive Care

Oakwood Southshore Medical Center

MI

利益声明

KC declares that he has no conflicts of interest.

鸣谢

Dr Kenneth Casey would like to gratefully acknowledge Dr Jwalant S. Mehta, a previous contributor to this topic. JSM declares that he has 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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