Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study  

作　　者：Hui Zhu James D.Guest Sarah Dunlop Jia-Xin Xie Sujuan Gao Zhuojing Luo Joe E.Springer Wutian Wu Wise Young Wai Sang Poon Song Liu Hongkun Gao Tao Yu Dianchun Wang Libing Zhou Shengping Wu Lei Zhong Fang Niu Xiaomei Wang Yansheng Liu Kwok-Fai So Xiao-Ming Xu 

机构地区：[1]Kunming Tongren Hospital,Kunming,Yunnan Province,China [2]Neurological Surgery,and the Miami Project to Cure Paralysis,Miller School of Medicine,University of Miami,Miami,FL,USA [3]School of Biological Sciences,The University of Western Australia,Perth,WA,Australia [4]Minderoo Foundation,Perth,WA,Australia [5]Clinical Center for Spinal Cord Injury,Kunming General Hospital of Chengdu Military Command,Kunming,Yunnan Province,China [6]Department of Biostatistics and Health Data Science,Indiana University School of Medicine,Indianapolis,IN,USA [7]Department of Orthopedic Spinal Surgery,Xijing Hospital,Fourth Military Medical University,Xi’an,Shaanxi Province,China [8]Spinal Cord and Brain Injury Research Center,Department of Physical Medicine and Rehabilitation,University of Kentucky College of Medicine,Lexington,KY,USA [9]Guangdong-HongKong-Macao Institute of CNS Regeneration,Jinan University,Guangzhou,Guangdong Province,China [10]W.M.Keck Center for Collaborative Neuroscience,Rutgers University,Piscataway,NJ,USA [11]Neurosurgery Department,Chinese University of Hong Kong,Prince of Wales Hospital,Hong Kong Special Administration Region,China [12]Spinal Cord and Brain Injury Research Group,Stark Neurosciences Research Institute,Department of Neurological Surgery,Indiana University School of Medicine,Indianapolis,IN,USA

出　　处：《Neural Regeneration Research》2024年第12期2773-2784,共12页中国神经再生研究（英文版）

基　　金：supported by Hong Kong Spinal Cord Injury Fund (HKSCIF),China (to HZ)。

摘　　要：For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.

关 键 词：chronic spinal cord injury intensive rehabilitation locomotor training neurological recovery surgical intervention weightbearing walking training 

分 类 号：R651.2[医药卫生—外科学]