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在儿童中SCIWORA. 一个罕见的临床实体:双重研究

L M Romero-Muñoz¹, M Peral-Alarma¹, A Barriga-Martín¹

¹Servicio de Cirugía Ortopédica y Traumatología, Hospital Nacional de Parapléjicos, Toledo, España.

Revista espanola de cirugia ortopedica y traumatologia

|September 9, 2023

概括

没有放射性异常的脊髓 (SCIWORA) 不成比例地影响儿童,由于机动车辆事故,大多数伤害发生在椎. 通过AIS等级D评估的功能恢复,在31%的患者中观察到退院一年后,并在五年内保持稳定.

科学领域:

神经学神经学
整形外科整形外科整形外科
创伤外科手术创伤外科

背景情况:

没有放射性异常的脊髓损伤 (SCIWORA) 由于其发病率低但功能影响显著,因此具有诊断挑战.
了解SCIWORA的流行病学和长期结果对于有效的患者管理至关重要.

研究的目的:

为了调查SCIWORA的流行病学特征.
评估SCIWORA患者的功能结果,长期随访长达10年.

主要方法:

进行了一项观察性,纵向的两样性队列研究.
收集的数据包括人口统计,损伤机制,MRI发现,神经状态 (ASIA损伤量表 - AIS) 和功能评分 (SCIM III,NDI,Oswestry,SV-QLI/SCI).
分析了13名SCIWORA患者,并将在2022年10月重新评估.

主要成果:

SCIWORA患者的平均年龄为4岁,77%是男性. 大多数受伤 (54%) 发生在椎,主要是机动车辆事故 (77%) 造成的.
在入院时,31%的患者有AIS等级A,31%的患者有AIS等级C. 功能性得分显示从入院到退院的情况有所改善 (SCIM III:28.5/42).
长期随访显示,31%的患者在1年内达到AIS等级D,这一比例在5年内保持不变. 在伤害机制/MRI发现和年龄/MRI发现之间没有发现显著的相关性.

结论:

SCIWORA主要影响幼儿,其中高比例的椎脊椎损伤与机动车辆事故有关.
很大一部分患者在一年内达到一定程度的功能恢复 (AIS等级D),并保持长期.
该研究强调了早期识别和管理SCIWORA的重要性,以优化这个脆弱人群的功能结果.

关键词:

儿童医院的年龄.造成骨髓损伤.脊髓是脊髓的一部分.儿科儿科儿科斯基沃拉 (SCIWORA) 是一个在脊髓中,脊髓是最重要的.脊髓损伤导致的脊髓损伤创伤是一个创伤.这是一种创伤主义 (traumatismo).

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