《中国康复理论与实践》 ›› 2020, Vol. 26 ›› Issue (2): 204-209.doi: 10.3969/j.issn.1006-9771.2020.02.011
收稿日期:
2019-04-15
修回日期:
2019-04-25
出版日期:
2020-02-25
发布日期:
2020-03-19
通讯作者:
李建军
E-mail:crrc100@163.com
作者简介:
刘宏炜(1985-),男,汉族,山西临汾市人,硕士,主治医师,主要研究方向:脊柱脊髓及周围神经损伤。
基金资助:
LIU Hong-wei1,2,LI Jian-jun1,2(),DU Liang-jie1,2,YANG Ming-liang1,2
Received:
2019-04-15
Revised:
2019-04-25
Published:
2020-02-25
Online:
2020-03-19
Contact:
LI Jian-jun
E-mail:crrc100@163.com
Supported by:
摘要:
老年人创伤性脊髓损伤的发病率和人群占比逐年升高,在发达国家已是脊髓损伤的主要受累人群。跌倒是最主要的受伤原因,椎管狭窄发生率增加、脊柱生物力学改变和过伸损伤可能是轻微创伤造成该人群脊髓损伤的发生机制。老年人创伤性脊髓损伤通常要接受早期手术治疗,当存在复杂的并发症、病情不稳定或脊髓损伤较轻,且不伴有明显骨折脱位时,可考虑非手术治疗和积极的康复,但具体手术指征、手术时机等还有争议。与年轻人相比,大部分老年患者表现为颈髓不全损伤,通过治疗和康复有望恢复更好的肢体功能,但生活自理能力恢复差,要监测脊髓损伤康复期间的功能变化并据此调整训练时长和强度等。
中图分类号:
刘宏炜,李建军,杜良杰,杨明亮. 老年人创伤性脊髓损伤研究进展[J]. 《中国康复理论与实践》, 2020, 26(2): 204-209.
LIU Hong-wei,LI Jian-jun,DU Liang-jie,YANG Ming-liang. Advance in Geriatric Traumatic Spinal Cord Injury (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(2): 204-209.
[1] | Pili R, Gaviano L, Pili L, et al. Ageing, disability, and spinal cord injury: some issues of analysis[J]. Curr Gerontol Geriatr Res, 2018, 2018:4017858. |
[2] |
Ahn H, Lewis R, Santos A, et al. Forecasting financial resources for future traumatic spinal cord injury care using simulation modeling[J]. J Neurotrauma, 2017, 34(20):2917-2923.
doi: 10.1089/neu.2016.4936 |
[3] |
Ahn H, Bailey C S, Rivers C S, et al. Effect of older age on treatment decisions and outcomes among patients with traumatic spinal cord injury[J]. CMAJ, 2015, 187(12):873-880.
doi: 10.1503/cmaj.150085 |
[4] | China-WHO. Country Cooperation Strategy 2016-2020 [EB/OL]. ( 2019-03-08). https://apps.who.int/iris/bitstream/handle/10665/206614/WPRO_2016_DPM_003_eng.pdf?sequence=1 |
[5] |
Jain N B, Ayers G D, Peterson E N, et al. Traumatic spinal cord injury in the United States, 1993-2012[J]. JAMA, 2015, 313(22):2236-2243.
doi: 10.1001/jama.2015.6250 |
[6] |
Chen Y, He Y, Devivo M J. Changing demographics and injury profile of new traumatic spinal cord injuries in the United States, 1972-2014[J]. Arch Phys Med Rehabil, 2016, 97(10):1610-1619.
doi: 10.1016/j.apmr.2016.03.017 |
[7] |
Thompson C, Mutch J, Parent S, et al. The changing demographics of traumatic spinal cord injury: an 11-year study of 831 patients[J]. J Spinal Cord Med, 2015, 38(2):214-223.
doi: 10.1179/2045772314Y.0000000233 pmid: 25096709 |
[8] |
Barbara-Bataller E, Mendez-Suarez J L, Aleman-Sanchez C, et al. Change in the profile of traumatic spinal cord injury over 15 years in Spain[J]. Scand J Trauma Resusc Emerg Med, 2018, 26(1):27.
doi: 10.1186/s13049-018-0491-4 |
[9] |
Halvorsen A, Pettersen A L, Nilsen S M, et al. Epidemiology of traumatic spinal cord injury in Norway in 2012-2016: a registry-based cross-sectional study[J]. Spinal Cord, 2019, 57(4):331-338.
doi: 10.1038/s41393-018-0225-5 pmid: 30573770 |
[10] |
McCaughey E J, Purcell M, Mclean A N, et al. Changing demographics of spinal cord injury over a 20-year period: a longitudinal population-based study in Scotland[J]. Spinal Cord, 2016, 54(4):270-276.
doi: 10.1038/sc.2015.167 pmid: 26458974 |
[11] |
Smith E, Fitzpatrick P, Murtagh J, et al. Epidemiology of traumatic spinal cord injury in Ireland, 2010-2015[J]. Neuroepidemiology, 2018, 51(1-2):19-24.
doi: 10.1159/000488146 |
[12] |
Ferro S, Cecconi L, Bonavita J, et al. Incidence of traumatic spinal cord injury in Italy during 2013-2014: a population-based study[J]. Spinal Cord, 2017, 55(12):1103-1107.
doi: 10.1038/sc.2017.88 pmid: 28872148 |
[13] | Toda M, Nakatani E, Omae K, et al. Age-specific characterization of spinal cord injuries over a 19-year period at a Japanese rehabilitation center[J]. PLoS One, 2018, 13(3):e195120. |
[14] |
Rahimi-Movaghar V, Sayyah M K, Akbari H, et al. Epidemiology of traumatic spinal cord injury in developing countries: a systematic review[J]. Neuroepidemiology, 2013, 41(2):65-85.
doi: 10.1159/000350710 pmid: 23774577 |
[15] |
Joseph C, Delcarme A, Vlok I, et al. Incidence and aetiology of traumatic spinal cord injury in Cape Town, South Africa: a prospective, population-based study[J]. Spinal Cord, 2015, 53(9):692-696.
doi: 10.1038/sc.2015.51 pmid: 25823800 |
[16] |
Yuan S, Shi Z, Cao F, et al. Epidemiological features of spinal cord injury in China: a systematic review[J]. Front Neurol, 2018, 9:683.
doi: 10.3389/fneur.2018.00683 |
[17] |
Li J, Liu G, Zheng Y, et al. The epidemiological survey of acute traumatic spinal cord injury (ATSCI) of 2002 in Beijing municipality[J]. Spinal Cord, 2011, 49(7):777-782.
doi: 10.1038/sc.2011.8 pmid: 21383758 |
[18] |
Fassett D R, Harrop J S, Maltenfort M, et al. Mortality rates in geriatric patients with spinal cord injuries[J]. J Neurosurg Spine, 2007, 7(3):277-281.
doi: 10.3171/SPI-07/09/277 |
[19] |
Reinhardt J D, Zheng Y, Xu G, et al. People with spinal cord injury in China[J]. Am J Phys Med Rehabil, 2017, 96(2 Suppl 1):S61-S65.
doi: 10.1097/PHM.0000000000000680 |
[20] |
Chen Y, Tang Y, Allen V, et al. Aging and spinal cord injury: external causes of injury and implications for prevention[J]. Top Spinal Cord Inj Rehabil, 2015, 21(3):218-226.
doi: 10.1310/sci2103-218 |
[21] | Bank M, Gibbs K, Sison C, et al. Age and other risk factors influencing long-term mortality in patients with traumatic cervical spine fracture[J]. Geriatr Orthop Surg Rehabil, 2018, 9:1468945214. |
[22] |
Goswami N, Blaber A P, Hinghofer-Szalkay H, et al. Orthostatic intolerance in older persons: etiology and countermeasures[J]. Front Physiol, 2017, 8:803.
doi: 10.3389/fphys.2017.00803 pmid: 29163185 |
[23] | Martin A R, De Leener B, Cohen-Adad J, et al. Can microstructural MRI detect subclinical tissue injury in subjects with asymptomatic cervical spinal cord compression? A prospective cohort study[J]. BMJ Open, 2018, 8(4):e19809. |
[24] |
Shigematsu H, Cheung J P, Mak K C, et al. Cervical spinal canal stenosis first presenting after spinal cord injury due to minor trauma: an insight into the value of preventive decompression[J]. J Orthop Sci, 2017, 22(1):22-26.
doi: S0949-2658(16)30176-2 pmid: 27713009 |
[25] |
Hagen E M, Aarli J A, Gronning M. The clinical significance of spinal cord injuries in patients older than 60 years of age[J]. Acta Neurol Scand, 2005, 112(1):42-47.
pmid: 15932355 |
[26] |
Fehlings M G, Tetreault L A, Riew K D, et al. A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression [J]. Global Spine J, 2017, 7(3 Suppl)70S-83S.
doi: 10.1177/2192568217701914 |
[27] |
Tetreault L A, Cote P, Kopjar B, et al. A clinical prediction model to assess surgical outcome in patients with cervical spondylotic myelopathy: internal and external validations using the prospective multicenter AOSpine North American and international datasets of 743 patients[J]. Spine J, 2015, 15(3):388-397.
doi: 10.1016/j.spinee.2014.12.145 pmid: 25549860 |
[28] | Davies B M, Mowforth O D, Smith E K, et al. Degenerative cervical myelopathy[J]. BMJ, 2018, 360:k186. |
[29] |
La Rosa G, Conti A, Cardali S, et al. Does early decompression improve neurological outcome of spinal cord injured patients? Appraisal of the literature using a meta-analytical approach[J]. Spinal Cord, 2004, 42(9):503-512.
pmid: 15237284 |
[30] | Yousefifard M, Rahimi-Movaghar V, Baikpour M, et al. Early versus late spinal decompression surgery in treatment of traumatic spinal cord injuries: a systematic review and meta-analysis[J]. Emerg (Tehran), 2017, 5(1):e37. |
[31] |
Inoue T, Suzuki S, Endo T, et al. Efficacy of early surgery for neurological improvement in spinal cord injury without radiographic evidence of trauma in the elderly[J]. World Neurosurg, 2017, 105:790-795.
doi: 10.1016/j.wneu.2017.06.070 |
[32] |
Zhao T, Yishmaan B L, Lin D, et al. Is delayed surgery after unsuccessful conservative treatment beneficial for spinal cord injury following whiplash? A retrospective study in elderly patients[J]. Med Sci Monit, 2018, 24:2818-2824.
doi: 10.12659/MSM.907091 |
[33] |
van Middendorp J J, Hosman A J, Doi S A. The effects of the timing of spinal surgery after traumatic spinal cord injury: a systematic review and meta-analysis [J]. J Neurotrauma, 2013, 30(21): 1781-1794.
doi: 10.1089/neu.2013.2932 |
[34] |
Dvorak M F, Noonan V K, Fallah N, et al. The influence of time from injury to surgery on motor recovery and length of hospital stay in acute traumatic spinal cord injury: an observational Canadian cohort study[J]. J Neurotrauma, 2015, 32(9):645-654.
doi: 10.1089/neu.2014.3632 |
[35] |
Du J P, Fan Y, Zhang J N, et al. Early versus delayed decompression for traumatic cervical spinal cord injury: application of the AOSpine subaxial cervical spinal injury classification system to guide surgical timing[J]. Eur Spine J, 2019, 28(8):1855-1863.
doi: 10.1007/s00586-019-05959-6 |
[36] |
Takao T, Okada S, Morishita Y, et al. Clinical influence of cervical spinal canal stenosis on neurological outcome after traumatic cervical spinal cord injury without major fracture or dislocation[J]. Asian Spine J, 2016, 10(3):536-542.
doi: 10.4184/asj.2016.10.3.536 |
[37] |
Okada S, Maeda T, Ohkawa Y, et al. Does ossification of the posterior longitudinal ligament affect the neurological outcome after traumatic cervical cord injury?[J]. Spine (Phila Pa 1976), 2009, 34(11):1148-1152.
doi: 10.1097/BRS.0b013e31819e3215 |
[38] |
Devivo M J, Kartus P L, Stover S L, et al. Seven-year survival following spinal cord injury[J]. Arch Neurol, 1987, 44(8):872-875.
doi: 10.1001/archneur.1987.00520200074023 |
[39] |
Poole L M, Le P, Drake R M, et al. Analysis of patients >/=65 with predominant cervical spine fractures: issues of disposition and dysphagia[J]. J Emerg Trauma Shock, 2017, 10(1):13-18.
doi: 10.4103/0974-2700.199518 pmid: 28243007 |
[40] |
Savic G, Devivo M J, Frankel H L, et al. Long-term survival after traumatic spinal cord injury: a 70-year British study[J]. Spinal Cord, 2017, 55(7):651-658.
doi: 10.1038/sc.2017.23 pmid: 28290467 |
[41] |
Cripps R A, Lee B B, Wing P, et al. A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention[J]. Spinal Cord, 2011, 49(4):493-501.
doi: 10.1038/sc.2010.146 pmid: 21102572 |
[42] |
Furlan J C, Fehlings M G. The impact of age on mortality, impairment, and disability among adults with acute traumatic spinal cord injury[J]. J Neurotrauma, 2009, 26(10):1707-1717.
doi: 10.1089/neu.2009.0888 |
[43] |
Ge L, Arul K, Ikpeze T, et al. Traumatic and nontraumatic spinal cord injuries[J]. World Neurosurg, 2018, 111:e142-e148.
doi: 10.1016/j.wneu.2017.12.008 |
[44] |
Frontera J E, Mollett P. Aging with spinal cord injury: an update[J]. Phys Med Rehabil Clin N Am, 2017, 28(4):821-828.
doi: 10.1016/j.pmr.2017.06.013 |
[45] |
Truchon C, Fallah N, Santos A, et al. Impact of therapy on recovery during rehabilitation in patients with traumatic spinal cord injury[J]. J Neurotrauma, 2017, 34(20):2901-2909.
doi: 10.1089/neu.2016.4932 |
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