150例脊髓损伤伴痉挛患者特点分析

doi:10.3969/j.issn.1006-9771.2026.04.003

Abstract

Abstract:

Objective To analyze the characteristics of 150 patients with spinal cord injury complicated with spasticity.

Methods A cross-sectional survey was conducted on 150 patients with spinal cord injury accompanied by spasticity from September, 2019 to December, 2024. Their age, gender, cause of injury, injury site, severity of injury, spasticity severity and other indicators were recorded. The relationships between different characteristics were analyzed, and a correlation analysis of disease duration, spasticity grade, injury level, injury severity and age were conducted.

Results There was no significant difference in age distribution between patients with tetraplegia and paraplegia (Z = 0.806, P = 0.420). The proportions of trauma (χ² = 3.982, P = 0.046) and tetraplegia (χ² = 10.559, P = 0.010) were higher in males than in females. Trauma was the main cause of injury in both tetraplegia and paraplegia patients; the proportion of tetraplegia was higher than paraplegia in trauma patients, while paraplegia was higher than tetraplegia in non-trauma patients (χ² = 11.885, P < 0.001). Patients with tetraplegia was dominated by incomplete injury, whereas patients with paraplegia was dominated by complete injury (χ² = 10.885, P = 0.012). Grade A injury was predominant in trauma patients (P = 0.003). Spasticity grade showed a very weak positive correlation with disease duration (r = 0.175, P = 0.032) and age (r = 0.168, P = 0.040). Injury severity showed a very weak positive correlation with age (r = 0.183, P = 0.025).

Conclusion Characteristics of patients with spinal cord injury complicated with spasticity is different with gender, cause of injury, injury level, injury severity.

Key words: spinal cord injury, spasticity, injury level, injury severity, American Spinal Injury Association Impairment Scale

CLC Number:

R651.2

LU Xiaolei, WANG Yiji, LIU Genlin, ZHENG Ying, HAO Chunxia, ZHANG Ying, KANG Haiqiong, WEI Bo, MENG Qianru, ZHOU Hongjun. Characteristics of 150 patients with spinal cord injury complicated with spasticity[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(4): 393-398.

Figures/Tables 6

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References 26

[1]	CRYNS N, HIMMELHAUS S, IRRGANG S, et al.; Acute Spinal Cord Injury Guideline Group. Clinical Practice Guideline: the Diagnosis and Treatment of Acute Spinal Cord Injury[J]. Dtsch Arztebl Int, 2025, 122(8): 219-224.
[2]	DIJKERS M P, ZANCA J M. Factors complicating treatment sessions in spinal cord injury rehabilitation: nature, frequency, and consequences[J]. Arch Phys Med Rehabil, 2013, 94(4 Suppl): S115-S124. doi: 10.1016/j.apmr.2012.11.047
[3]	LANCE J W. The control of muscle tone, reflexes, and movement: Robert Wartenberg Lecture[J]. Neurology, 1980, 30(12): 1303-1313. doi: 10.1212/wnl.30.12.1303 pmid: 7192811
[4]	ELBASIOUNY S M, MOROZ D, BAKR M M, et al. Management of spasticity after spinal cord injury: current techniques and future directions[J]. Neurorehabil Neural Repair, 2010, 24(1): 23-33. doi: 10.1177/1545968309343213 pmid: 19723923
[5]	PANDYAN A D, GREGORIC M, BARNES M P, et al. Spasticity: clinical perceptions, neurological realities and meaningful measurement[J]. Disabil Rehabil, 2005, 27(1/2): 2-6. doi: 10.1080/09638280400014576
[6]	ANDRESEN S R, BIERING-SØRENSEN F, HAGEN E M, et al. Pain, spasticity and quality of life in individuals with traumatic spinal cord injury in Denmark[J]. Spinal Cord, 2016, 54(11): 973-979. doi: 10.1038/sc.2016.46 pmid: 27067654
[7]	MAHONEY J S, ENGEBRETSON J C, COOK K F, et al. Spasticity experience domains in persons with spinal cord injury[J]. Arch Phys Med Rehabil, 2007, 88(3): 287-294. doi: 10.1016/j.apmr.2006.12.029
[8]	SKÖLD C, LEVI R, SEIGER A. Spasticity after traumatic spinal cord injury: nature, severity, and location[J]. Arch Phys Med Rehabil, 1999, 80(12): 1548-1557. doi: 10.1016/S0003-9993(99)90329-5
[9]	HOLTZ K A, LIPSON R, NOONAN V K, et al. Prevalence and effect of problematic spasticity after traumatic spinal cord injury[J]. Arch Phys Med Rehabil, 2017, 98(6): 1132-1138. doi: 10.1016/j.apmr.2016.09.124
[10]	美国脊髓损伤协会, 国际脊髓损伤学会. 脊髓损伤神经学分类国际标准(2011年修订)[J]. 李建军,王方永,译. 中国康复理论与实践, 2011, 17(10): 963-972.
	American Spinal Injury Association, International Spinal Cord Society. International Standards for Neurological Classification of Spinal Cord Injury[J]. LI J J, WANG F Y, trans. Chin J Rehabil Theroy Pract, 2011, 17(10): 963-972.
[11]	王一吉, 周红俊, 李建军, 等. 脊髓损伤神经学分类国际标准检查表最新修订及解读[J]. 中国康复理论与实践, 2015, 21(8): 879-882.
	WANG Y J, ZHOU H J, LI J J, et al. Latest edition and interpretation of International Standards for Neurological Classification of Spinal Cord Injury Worksheet[J]. Chin J Rehabil Theory Pract, 2015, 21(8): 879-882.
[12]	康海琼, 周红俊, 刘根林, 等. 脊髓损伤神经学分类国际标准检查表2019版最新修订及解读[J]. 中国康复理论与实践, 2019, 25(8): 983-985. doi: 10.3969/j.issn.1006-9771.2019.00.009
	KANG H Q, ZHOU H J, LIU G L, et al. Modification and interpretation of the 2019 International Standards for Neurological Classification of Spinal Cord Injury Worksheet[J]. Chin J Rehabil Theory Pract, 2019, 25(8): 983-985.
[13]	李建军, 杨明亮, 杨德刚, 等. "创伤性脊柱脊髓损伤评估、治疗与康复"专家共识[J]. 中国康复理论与实践, 2017, 23(3): 274-287. doi: 10.3969/j.issn.1006-9771.2017.03.007
	LI J J, YANG M L, YANG D G, et al. Expert Consensus on Evaluation, Treatment and Rehabilitation of Traumatic Spinal Cord Injury[J]. Chin J Rehabil Theory Pract, 2017, 23(3): 274-287.
[14]	BOHANNON R W, SMITH M B. Interrater reliability of a modified Ashworth Scale of Muscle Spasticity[J]. Phys Ther, 1987, 67: 206-207. doi: 10.1093/ptj/67.2.206 pmid: 3809245
[15]	GONG H, ZHANG Z Y, DUAN Z X, et al. Mechanisms of different motor neurons in the occurrence of spasticity after spinal cord injury: a narrative review[J]. Int J Mol Sci, 2025, 26(11): 5162. doi: 10.3390/ijms26115162
[16]	BILLINGTON Z J, HENKE A M, GATER D R, et al. Spasticity management after spinal cord injury: the here and now[J]. J Pers Med, 2022, 12(5): 808. doi: 10.3390/jpm12050808
[17]	PHADKE C P, BALASUBRAMANIAN C K, ISMAIL F, et al. Revisiting physiologic and psychologic triggers that increase spasticity[J]. Am J Phys Med Rehabil, 2013, 92: 357-369. doi: 10.1097/PHM.0b013e31827d68a4
[18]	郝春霞, 李建军, 周红俊, 等. 1264例住院脊髓损伤患者的流行病学分析[J]. 中国康复理论与实践, 2007, 13(11): 1011-1013.
	HAO C X, LI J J, ZHOU H J, et al. Epidemiology characteristics of spinal cord injury in hospital: 1264 cases report[J]. Chin J Rehabil Theory Pract, 2007, 13(11): 1011-1013.
[19]	李建军, 周红俊, 洪毅, 等. 2002年北京市脊髓损伤发病率调查[J]. 中国康复理论与实践, 2004, 10(7): 412-413.
	LI J J, ZHOU H J, HONG Y, et al. Spinal cord injuries in Beijing:a municipal epidemiological survey in 2002[J]. Chin J Rehabil Theory Pract, 2004, 10(7): 412-413.
[20]	SEKHON L H, FEHLINGS M G. Epidemiology, demographics, and pathophysiology of acute spinal cord injury[J]. Spine (Phila Pa 1976), 2001, 26(24 Suppl): S2-S12. doi: 10.1097/00007632-200112151-00002
[21]	MAYNARD F M, KARUNAS R S, WARING W P 3rd, et al. Epidemiology of spasticity following traumatic spinal cord injury[J]. Arch Phys Med Rehabil, 1990, 71: 566-569.
[22]	SKOOG B, JAKOBSSON K E. Prevalence of spasticity and below-level neuropathic pain related to spinal cord injury level and damage to the lower spinal segments[J]. Rehabil Med Clin Commun, 2020, 3: 1000039.
[23]	MILLS P B, HOLTZ K A, SZEFER E, et al. Early predictors of developing problematic spasticity following traumatic spinal cord injury: a prospective cohort study[J]. Spinal Cord Med, 2020, 43(3): 315-330.
[24]	DRAGOJLOVIC N, ROMANOSKI N L, VERDUZCO-GUTIERREZ M, et al. Prevalence and treatment characteristics of spastic hypertonia on first-time admission to acute inpatient rehabilitation[J]. Am J Phys Med Rehabil, 2022, 101(4): 348-352. doi: 10.1097/PHM.0000000000001823
[25]	LEVASSEUR A, MAC-THIONG J M, RICHARD-DENIS A. Are early clinical manifestations of spasticity associated with long-term functional outcome following spinal cord injury? A retrospective study [J]. Spinal Cord, 2021, 59: 910-916. doi: 10.1038/s41393-021-00661-1 pmid: 34230603
[26]	中国残疾人康复协会脊髓损伤康复专业委员会. 创伤性脊柱脊髓损伤的系统管理及常见并发症处理专家共识(2022版)[J]. 中国老年保健医学, 2022, 20(4): 10-15.

类别	分类	n
性别	男	117
	女	33
年龄	≤ 30岁	53
	> 30~60岁	86
	> 60岁	11
致伤原因	外伤	127
	非外伤	23
患病时间	< 6个月	25
	6个月~1年	34
	< 1~2年	43
	> 2年	48
损伤平面	颈髓损伤	82
	胸髓损伤	67
	胸12以下损伤	1
AIS	A级	63
	B级	26
	C级	29
	D级	32
	E级	0
痉挛分级	四肢瘫	82
	下肢痉挛且伴有上肢痉挛	28
	下肢痉挛但不伴有上肢痉挛	54
	截瘫	68
	1级	9
	1⁺级	6
	2级	44
	3级	9
	4级	0
痉挛分级	下肢痉挛分级
	1级	19
	1⁺级	11
	2级	99
	3级	20
	4级	1

致伤原因	n	AIS分级
致伤原因	n	A	B	C	D
外伤	127	58	23	26	20
非外伤	23	5	3	3	12

痉挛分级	性别		瘫痪类型		致伤原因		AIS				患病时间/年
痉挛分级	男	女	四肢瘫	截瘫	外伤	非外伤	A	B	C	D	< 0.5	0.5~1	1~2	> 2
1	13	5	9	9	14	4	9	1	1	7	4	3	8	3
1⁺	8	3	5	6	8	3	9	1	1	0	3	4	2	2
2	80	19	56	43	88	11	38	19	23	19	16	30	18	35
3	15	6	11	10	16	5	6	5	4	6	2	5	6	8
4	1	0	1	0	1	0	1	0	0	0	0	0	1	0
P值	0.671		0.910		0.234		0.082				0.292

项目	患病时间		痉挛分级		AIS
项目	r值	P值	r值	P值	r值	P值
痉挛分级	0.175	0.032
AIS	-0.061	0.461	0.073	0.374
年龄	0.132	0.107	0.168	0.040	0.183	0.025

Characteristics of 150 patients with spinal cord injury complicated with spasticity

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