儿童舞蹈活动致急性脊髓损伤的治疗分析(附8例报道并文献复习)  

Clinical analysis of acute spinal cord injury caused by children's dancing activities:eight cases report and literature review

作　　者：苏建云[1] 强召展 杨张凯 米伟阳 张刚[1] 史永强[1] 李楠[1] 史航宇[1] SU Jian-yun;QIANG Zhao-zhan;YANG Zhang-kai;MI Wei-Yang;ZHANG Gang;SHI Yong-qiang;LI Nan;SHI Hang-yu(Department of Neurosurgery,Xi`an Children`s Hospital,Xi`an 710003,China)

机构地区：[1]西安市儿童医院神经外科,710003

出　　处：《中国临床神经外科杂志》2022年第4期249-251,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨儿童舞蹈活动致急性脊髓损伤的临床特征、影像学特点、治疗方法及效果。方法回顾性分析2016年1月至2020年12月收治的8例儿童因舞蹈活动致急性脊髓损伤的临床资料,并结合文献进行分析。结果8例年龄5.5岁~7.5岁,平均(6.33±0.68)岁。入院ASIA分级A级2例,C级4例,D级2例。CT未见脊柱骨折或关节脱位。脊髓MRI扫描示损伤水平在T1~L1节段,脊髓缺血、肿胀,呈稍长T_(1)、长T_(2)异常信号。6例伤后12 h内入院(ASIA分级A级2例、C级3例、D级1例),接受甲基强的松龙激素静脉冲击治疗。6例(入院时ASIA分级C级4例、D级2例)伤后6个月恢复至E级,2例入院时ASIA分级A级伤后6个月仍为A级。结论儿童舞蹈活动可导致脊髓损伤,具有年龄相关性,损伤机制可能与脊柱极度弯曲导致局部血管痉挛缺血相关,远期预后与原发性损伤程度相关,MRI检查显示病变弥漫且进展提示预后较差。Objective To explore the clinical characteristics,imaging features,treatment and outcomres of children with spinal cord injury caused by dancing activities.Methods A retrospective analysis was performed on the clinical data of 8 children with acute spinal cord injury caused by dancing activity who were admitted to our hospital from January 2016 to December 2020.The relevant literatures were reviewed.Results The age of 8 chinldren ranged from 5.5 years to 7.5 years,with an average of(6.33±0.68)years.Two patients were classified as ASIA grade A,4 as grade C,and 2 as grade D on admition.Spinal CT showed no fracture or dislocation in all the patients.Spinal MRI showed that the injury was located in the T1~L1 segments of spinal cord,and the spinal cord was ischemia and swelling with abnormal signals of slightly longer T_(1) and longer T_(2).Six patients who were admitted to hospital within 12 hours after injury(2 patients of ASIA grade A,3 of grade C,and 1 of grade D)received high-dose methylprednisolone treatment.Of 8 children,6 children(4 cases of ASIA grade C and 2 of D grade on admission)recovered to grade E 6 months after injury,and 2 children of ASIA grade A were still classified as grade A 6 months after injury.Conclusions Dance activities can result in spinal cord injury in school-age children.The injury mechanism may be related to local vasospasm and ischemia of spincal cord caused by extreme curvature of the spine.The long-term prognosis is related to the degree of primary injury.MRI examination showing diffuse lesions and progression indicates a poor prognosis.

关 键 词：脊髓损伤 学龄儿童 舞蹈损伤 影像学特征 临床特征 

分 类 号：R683.2[医药卫生—骨科学]