Abstract

Secondary spinal cord changes can follow spinal cord injuries (SCIs). This retrospective study was to uncover the chronic secondary changes that affect the spinal cord following severe injuries and to evaluate the influence of residual spinal deformity in the development of posttraumatic spinal cord changes. Fifty-eight patients (39 male, 19 female) with complete traumatic SCI and recent Magnetic resonance imaging (MRI) follow-up were reviewed retrospectively. A minimum of 2 years duration between trauma and MRI study was required (mean 2.9 years [2.1–4.7]). Two groups of patients were formed: with spinal deformity (and or spinal canal compromise) and without spinal deformity (and or spinal canal compromise). MRI of the injured spine demonstrated four major types of spinal cord changes; these are spinal cord atrophy, myelomalacia, syrinx, and focal cyst formation. The correlation of these changes to the presence of spinal deformity and or spinal canal compromise was also studied. Twenty-three patients (40%) of the studied population had more than 30° kyphosis and or 50% compromise of the spinal canal. Chronic spinal cord changes occurred in 25 patients (43%), 17 of these changes occurred in patients with spinal deformity and the remaining 8 occurred in patients without spinal deformity or canal compromise (p ≤ .05). The prevalence of spinal cord atrophy and focal cysts was significantly higher in patients with residual deformity and or spinal canal compromise (p ≤ .05). The authors recommend proper spinal cord decompression and fixation for patients with complete SCI to reduce the chance of secondary SCI.

摘要

继发性脊髓改变可发生在脊髓损伤 (SCI) 之后。这项回顾性研究旨在揭示严重损伤后影响脊髓的慢性继发性变化，并评估残余脊柱畸形对创伤后脊髓变化发展的影响。对 58 名患有完全创伤性 SCI 和近期磁共振成像 (MRI) 随访的患者（39 名男性，19 名女性）进行了回顾性研究。创伤和 MRI 研究之间需要至少 2 年的持续时间（平均 2.9 年 [2.1-4.7]）。形成两组患者：脊柱畸形（和/或椎管受损）和无脊柱畸形（和/或椎管受损）。受伤脊柱的 MRI 显示四种主要类型的脊髓变化；这些是脊髓萎缩、骨髓软化、空洞，和局灶性囊肿形成。还研究了这些变化与脊柱畸形和/或椎管损伤的相关性。研究人群中有 23 名患者 (40%) 有超过 30° 的后凸畸形和/或 50% 的椎管受损。25 名患者（43%）发生了慢性脊髓改变，其中 17 名发生在脊柱畸形患者中，其余 8 名发生在没有脊柱畸形或椎管受损的患者中。p  ≤ .05）。有残余畸形和/或椎管损伤的患者脊髓萎缩和局灶性囊肿的患病率显着更高 ( p  ≤ .05)。作者建议对完全性 SCI 患者进行适当的脊髓减压和固定，以减少继发性 SCI 的机会。