Spinal cord最新文献_第4页

Surgical and conservative treatment of lower limb fractures in patients with chronic spinal cord injury 慢性脊髓损伤患者下肢骨折的手术与保守治疗。

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-11-07 DOI: 10.1038/s41393-025-01138-1

Frederik Wilhelm Schneckmann, Alexander Klug, Tim Jakobi, Annika Werner, Anne Bauer, Matthias Münzberg, Stephan Kurz

A 10-year single-center retrospective chart review. To evaluate the differences between conservative and surgical treatment of long bone fractures in individuals with chronic SCI, focusing on wheelchair mobilization, overall hospital days, and complication rates. Spinal cord injury Department, BG Trauma Center Frankfurt am Main, Germany. The study, conducted between 2014 and 2023, compared conservative and surgical treatment for long bone fractures in individuals with chronic SCI using descriptive statistics. Fifty-eight fractures were included (31 surgical, 27 conservative). Baseline characteristics did not differ between groups (p > 0.05). Median time to first wheelchair mobilization was 14 days in both groups (median difference 0 days; 95% CI, –4 to 5; p = 0.38). LOS was comparable (median 45 vs. 46 days; difference –1 day; 95% CI, –7 to 6; p = 0.98). Complications occurred in 1 of 31 surgically treated cases (3.2%) versus 9 of 27 conservatively treated (33.3%), corresponding to a risk difference of –30.1% (95% CI, –48.3 to –11.9; p = 0.002). Non-surgical treatment had a higher complication rate than surgical treatment. Both approaches were equivalent in time to first wheelchair mobilization, and neither showed a significantly shorter hospital stay.

研究设计：10年单中心回顾性图表回顾。目的：评估慢性脊髓损伤患者长骨骨折的保守治疗与手术治疗的差异，重点关注轮椅活动、总住院天数和并发症发生率。单位：德国法兰克福BG创伤中心脊髓损伤科。方法：该研究于2014年至2023年间进行，采用描述性统计方法比较了慢性脊髓损伤患者长骨骨折的保守治疗和手术治疗。结果：58例骨折（手术骨折31例，保守骨折27例）。各组间基线特征无差异（p < 0.05）。两组患者第一次轮椅移动的中位时间为14天（中位差为0天；95% CI， -4至5；p = 0.38）。LOS具有可比性（中位45天vs. 46天；差-1天；95% CI, -7 ~ 6; p = 0.98）。31例手术治疗患者中有1例（3.2%）发生并发症，27例保守治疗患者中有9例（33.3%）发生并发症，相应的风险差异为-30.1% （95% CI, -48.3至-11.9;p = 0.002）。结论：非手术治疗并发症发生率高于手术治疗。两种方法在时间上都与第一次轮椅移动相同，并且都没有显示出明显缩短住院时间。

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引用次数: 0

Active living lifestyles for manual wheelchair users (ALLWheel) program to enhance leisure time physical activity: a pilot randomized control trial 积极的生活方式为手动轮椅使用者（ALLWheel）计划增加闲暇时间的身体活动：一项试点随机对照试验。

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-11-06 DOI: 10.1038/s41393-025-01135-4

Zhiyang Shi, Shane N. Sweet, François Routhier, Jaimie Borisoff, Kelly P. Arbour-Nicitopoulos, Krista L. Best

A 3-city pilot randomized controlled trial. To evaluate the efficacy of an Active Living Lifestyles for manual Wheelchair users (ALLWheel) program for increasing participants’ leisure time physical activity, motivation, self-efficacy, and satisfaction of basic psychological needs from baseline to post-program (10 weeks) and at follow-up (3 months post-program). Rehabilitation centers and community. Forty adult community-dwelling manual wheelchair users with spinal cord injury were allocated to an intervention (n = 20) or control group (n = 20). The intervention group received a 10-week ALLWheel program. Leisure time physical activity, motivation, self-efficacy, and satisfaction of basic psychological needs were measured at baseline, post-intervention, and 3-month follow-up. Group differences were examined. The intervention and the control groups had a significant difference in total leisure time physical activity post-intervention, with a small effect size (Relative Treatment Effect = 0.38, p < 0.05). This difference was not significant at follow-up. The two groups had a significant difference in moderate-heavy leisure time physical activity post-intervention, with a small effect size (Relative Treatment Effect = 0.36, p < 0.05). This difference was not significant at follow-up. No significant group differences were found for the psychological outcomes post-intervention or at follow-up. The ALLWheel program had a small effect size for increasing adult wheelchair users’ total leisure time physical activity levels post-intervention, particularly for moderate-to-heavy intensity. However, this increase was not maintained at the 3-month follow-up. Additional refinement and testing of the ALLWheel program is warranted before moving to a larger-scale randomized control trial with active control groups.

研究设计：3个城市的随机对照试验。目的：评估积极生活方式对手动轮椅使用者（ALLWheel）项目的有效性，从基线到项目后（10周）和随访（项目后3个月），增加参与者的休闲时间体力活动、动机、自我效能和基本心理需求的满意度。环境：康复中心和社区。方法：将40例脊髓损伤的成人社区手工轮椅使用者分为干预组（n = 20）和对照组（n = 20）。干预组接受为期10周的ALLWheel项目。在基线、干预后和3个月随访时测量休闲时间体力活动、动机、自我效能感和基本心理需求满意度。观察组间差异。结果：干预组与对照组在干预后的总休闲时间体力活动上差异有统计学意义，但效应量较小（相对治疗效应= 0.38,p < 0.05）。在随访中，这一差异不显著。两组干预后中重度休闲时间体力活动差异有统计学意义，但效应量较小（相对治疗效应= 0.36,p < 0.05）。在随访中，这一差异不显著。干预后或随访时的心理结果没有发现显著的组间差异。结论：ALLWheel项目对增加成年轮椅使用者在干预后的总休闲时间体力活动水平有较小的效应，特别是对中至高强度的体力活动。然而，在3个月的随访中，这种增加并未保持。在进行更大规模的随机对照试验之前，需要对ALLWheel项目进行进一步的改进和测试。

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引用次数: 0

Passive movement interventions and spasticity outcomes in individuals with spinal cord injury during rehabilitation: a scoping review 康复期间脊髓损伤患者的被动运动干预和痉挛结果：范围综述。

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-11-05 DOI: 10.1038/s41393-025-01141-6

Samuel David Williamson, Anders Orup Aaby, Anine Overgaard Ejersbo, Marianne Rahbek Vestergaard, Sophie Lykkegaard Ravn

Scoping review. Spasticity is a common and often challenging sequela of spinal cord injury (SCI) associated with pain, contractures, and reduced quality of life. While passive movement (PM) is primarily used to maintain joint mobility, clinical observations and participant reports suggest that both manual and automated techniques can contribute to the management of spasticity in SCI. However, the evidence base concerning PM’s impact on spasticity outcomes in SCI populations remains unclear. This review aims to identify the scope and synthesize the empirical evidence of PM interventions for managing spasticity in individuals with SCI. Seven databases (Embase, Medline, PsycInfo, Web of Science, Scopus, CENTRAL, and CINAHL) were systematically searched. Eligible studies were peer-reviewed, reported original data, included adult participants (≥18 years) with SCI, presented a therapeutic intervention consisting solely of PM techniques, and reported any spasticity outcome. Data were extracted and analyzed by two independent reviewers. The initial search identified 1628 unique studies, of which 13 were included for analysis. The PM interventions included passive cycling and robotic PM interventions (n = 8), continuous passive motion (n = 4), and manual passive range of motion (PROM) (n = 1). While a minority of studies demonstrated sustained improvements in spasticity outcomes, the majority reported short-term reductions observed in small sample groups, single-session experiments, or using suboptimal research designs. This review assembled the existing evidence on PM interventions for managing spasticity in individuals with SCI. Despite finding consistent short-term improvements, further high-quality research is needed to determine clinical efficacy and inform future rehabilitation practices.

研究设计：范围审查。目的：痉挛是脊髓损伤（SCI）的一种常见且具有挑战性的后遗症，与疼痛、挛缩和生活质量下降有关。虽然被动运动（PM）主要用于维持关节活动，但临床观察和参与者报告表明，手动和自动技术都有助于脊髓损伤痉挛的管理。然而，关于PM对脊髓损伤人群痉挛结果影响的证据基础仍不清楚。本综述旨在确定PM干预治疗脊髓损伤患者痉挛的范围和综合经验证据。方法：系统检索Embase、Medline、PsycInfo、Web of Science、Scopus、CENTRAL、CINAHL 7个数据库。符合条件的研究经过同行评审，报告了原始数据，包括SCI的成年参与者（≥18岁），提出了仅由PM技术组成的治疗干预，并报告了任何痉挛结果。数据由两名独立审稿人提取和分析。结果：最初的搜索确定了1628个独特的研究，其中13个被纳入分析。PM干预包括被动骑车和机器人PM干预（n = 8），连续被动运动（n = 4）和手动被动运动范围（n = 1）。虽然少数研究表明痉挛结果持续改善，但大多数研究报告在小样本组，单次实验或使用次优研究设计中观察到短期减少。结论：本综述收集了PM干预治疗脊髓损伤患者痉挛的现有证据。尽管发现了持续的短期改善，但需要进一步的高质量研究来确定临床疗效并为未来的康复实践提供信息。

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引用次数: 0

Community opioid dispensing prevalence and patterns in adults with spinal cord injury in Queensland: a retrospective data linkage study 昆士兰州脊髓损伤成人社区阿片类药物分发流行率和模式：一项回顾性数据链接研究

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-11-04 DOI: 10.1038/s41393-025-01136-3

Samantha J. Borg, Victoria McCreanor, Timothy Geraghty, Karen Luetsch, Steven M. McPhail, Susanna Cramb, Rania Shibl, Melanie Proper, Bill Loveday, Cate M. Cameron

Population-based data linkage of state-based opioid dispensing, hospital administrative and death registry data. This study aimed to provide a detailed overview of opioid dispensing in the 2-years following SCI. Community. Linked data were obtained for adults admitted to Queensland hospitals with a newly diagnosed traumatic or non-traumatic SCI from 1 January 2014–31 December 2017. Community opioid dispensing data was obtained for 3 months pre-SCI and up to two years after their Index Hospital Admission for SCI. Chronic dispensing (≥90 cumulative dispensing days) and high end dose (median daily dose of 50 or more oral morphine equivalents in the last 3 months of dispensing) were calculated from dispensing data. Of the 298 included cases (180 traumatic; 118 non-traumatic), 1 or more opioids were dispensed to 19% of the cohort in the 3 months pre-SCI (40% non-traumatic SCI; 6% traumatic SCI) and to 53% post-SCI (56% non-traumatic SCI; 52% traumatic SCI). Those who were dispensed opioids pre-SCI were 3.7 times more likely to have been dispensed opioids in the observation period (95% confidence interval: 1.90, 7.24, p < 0.001). Thirty percent of the cohort have been dispensed opioids chronically. High opioid end doses were significantly more likely among those with non-traumatic SCI. Whilst it was positive that many were not dispensed an opioid post-SCI, the high prevalence of high opioid doses and chronic duration is concerning. The reliance on opioids for pain management suggests stronger approaches to coordinated and improved multi-disciplinary long-term pain management is needed.

研究设计：以人口为基础的阿片类药物配药、医院管理和死亡登记数据的数据链接。目的：本研究旨在提供脊髓损伤后2年内阿片类药物分配的详细概述。设置:社区。方法：获取2014年1月1日至2017年12月31日期间在昆士兰医院新诊断为创伤性或非创伤性脊髓损伤的成年人的相关数据。社区阿片类药物分配数据是在脊髓损伤前3个月和他们因脊髓损伤入院后两年获得的。根据配药数据计算慢性配药（累计配药天数≥90天）和高端剂量（配药后3个月内每日剂量中位数≥50口服吗啡当量）。结果：在298例纳入的病例中（180例创伤性，118例非创伤性），19%的患者在脊髓损伤前3个月（40%非创伤性脊髓损伤，6%创伤性脊髓损伤）和53%的患者在脊髓损伤后3个月（56%非创伤性脊髓损伤，52%创伤性脊髓损伤）使用了1种或1种以上的阿片类药物。那些在脊髓损伤前服用阿片类药物的患者在观察期内服用阿片类药物的可能性是其他患者的3.7倍（95%可信区间：1.90,7.24,p）。结论：虽然许多患者在脊髓损伤后没有服用阿片类药物是积极的，但高阿片类药物剂量和慢性持续时间的高患病率令人担忧。对阿片类药物疼痛管理的依赖表明，需要更强有力的方法来协调和改进多学科的长期疼痛管理。

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引用次数: 0

Targeting astrocyte-monocyte-neuron crosstalk in spinal cord injury: therapeutic insights from methyl gallate. 靶向星形胶质细胞-单核细胞-神经元串扰在脊髓损伤中的作用：来自没食子酸甲酯的治疗见解。

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-10-29 DOI: 10.1038/s41393-025-01127-4

Xing Zhao, Miao Bai, Hang Li, Lili Lian, Qiuru Li

Study design: Integrative multi-omics cross-sectional study combining scRNA-seq, bulk transcriptomics, Mendelian randomization, and network pharmacology with molecular docking.

Objective: To investigate the therapeutic mechanisms of methyl gallate (MG) in spinal cord injury (SCI) through the lens of cell-type-specific pathways and immune regulation.

Setting: Publicly available SCI transcriptomic datasets and GWAS summary data were analyzed using established bioinformatics platforms.

Methods: This study integrated single-cell RNA sequencing (scRNA-seq), transcriptomics, genome-wide association study (GWAS)-based Mendelian randomization (MR), and network pharmacology to explore MG's effects on SCI. Temporal scRNA-seq profiles were analyzed from mice with subacute SCI (days 3 to 14 post-injury) to identify changes in astrocyte dynamics and glia-neuron interactions. Differential gene expression and functional enrichment analyses were performed, followed by drug-target prediction and molecular docking.

Results: scRNA-seq revealed a significant reduction in astrocyte populations and disrupted astrocyte-monocyte-neuron communication post-SCI. A total of 959 astrocyte-specific and 1,459 SCI-related differentially expressed genes (DEGs) were identified. Enrichment analyses highlighted neuroimmune and inflammatory pathways. MR indicated a protective association between elevated monocyte count and reduced SCI risk. Network pharmacology and molecular docking demonstrated that MG targets overlapped with astrocyte DEGs, suggesting high binding affinities and regulatory effects on inflammation and neuron-glia signaling.

Conclusions: MG may promote recovery from SCI by modulating neuroimmune interactions, particularly through astrocyte and monocyte-mediated pathways. The integrative multi-omics strategy supports MG's translational potential as a novel therapeutic candidate for SCI. Mechanism of SCI Repair and Neuronal Differentiation Mediated by MG (Created by BioRender).

研究设计：综合多组学横断面研究，结合scRNA-seq、大量转录组学、孟德尔随机化和网络药理学与分子对接。目的：从细胞特异性途径和免疫调节角度探讨没食子酸甲酯（methyl gallate， MG）治疗脊髓损伤（SCI）的机制。设置：使用已建立的生物信息学平台分析公开可用的SCI转录组数据集和GWAS汇总数据。方法：本研究结合单细胞RNA测序（scRNA-seq）、转录组学、基于孟德尔随机化（MR）的全基因组关联研究（GWAS）和网络药理学，探讨MG对脊髓损伤的影响。对亚急性脊髓损伤小鼠（损伤后3 - 14天）的颞叶scRNA-seq谱进行分析，以确定星形胶质细胞动力学和胶质神经元相互作用的变化。进行差异基因表达和功能富集分析，然后进行药物靶点预测和分子对接。结果：scRNA-seq显示，sci后星形胶质细胞数量显著减少，星形胶质细胞-单核细胞-神经元通讯中断。共鉴定出959个星形胶质细胞特异性基因和1459个sci相关差异表达基因（deg）。富集分析强调了神经免疫和炎症途径。磁共振显示单核细胞计数升高与脊髓损伤风险降低之间存在保护性关联。网络药理学和分子对接表明，MG靶点与星形胶质细胞deg重叠，提示高结合亲和力和对炎症和神经元-胶质信号传导的调节作用。结论：MG可能通过调节神经免疫相互作用促进脊髓损伤的恢复，特别是通过星形胶质细胞和单核细胞介导的途径。综合多组学策略支持MG作为一种新的脊髓损伤治疗候选药物的转化潜力。MG介导的脊髓损伤修复及神经元分化机制。

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引用次数: 0

Comparison of surgical and clinical outcomes between ventral and dorsal/lateral thoracic intradural extramedullary meningiomas: a retrospective study. 腹侧和背侧胸椎硬膜内/髓外脑膜瘤的手术和临床结果比较：一项回顾性研究。

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-10-27 DOI: 10.1038/s41393-025-01132-7

Yu Suematsu, Narihito Nagoshi, Toshiki Okubo, Masahiro Ozaki, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Morio Matsumoto, Masaya Nakamura, Kota Watanabe

Study design: Retrospective comparative study.

Objectives: To compare surgical and clinical outcomes of thoracic intradural extramedullary (IDEM) meningiomas based on tumor location, specifically between ventral and dorsal/lateral lesions.

Methods: This study retrospectively analyzed 60 consecutive patients who underwent posterior surgical resection for thoracic IDEM meningiomas at a single institution between 2007 and 2022. Patients were stratified into two groups according to tumor location on preoperative MRI: Ventral group (n = 23) and Dorsal/Lateral group (n = 37). Clinical outcomes were assessed using the modified McCormick scale (MMCS). Surgical parameters and complications were also compared.

Results: Patients in the Ventral group had significantly larger sagittal tumor diameters and higher spinal canal occupancy rates than those in the Dorsal/Lateral group (p < 0.05). Preoperative motor deficits were more frequent in the Ventral group (86.9 vs. 51.3%, p < 0.01). Estimated blood loss was greater in the Ventral group (p = 0.01). Intraoperative motor evoked potential deterioration occurred more often (p = 0.04). Although both groups showed neurological improvement postoperatively, the percentage of patients reaching MMCS Grade I at final follow-up was significantly lower in the Ventral group (17.3 vs. 54.0%, p < 0.01). No tumor recurrence was observed in either group during the follow-up period (mean: 61.4 months).

Conclusions: Ventrally located thoracic IDEM meningiomas are associated with more severe preoperative motor dysfunction and inferior postoperative neurological recovery compared to dorsal/lateral lesions. These findings highlight the importance of early surgical intervention and tailored surgical planning for ventral tumors to optimize functional outcomes.

研究设计：回顾性比较研究。目的：比较胸硬膜内髓外（IDEM）脑膜瘤的手术和临床结果，基于肿瘤的位置，特别是腹侧和背侧病变之间。方法：本研究回顾性分析了2007年至2022年间在同一医院接受后路手术切除胸椎IDEM脑膜瘤的60例连续患者。根据术前MRI显示的肿瘤位置将患者分为腹侧组（n = 23）和背侧/外侧组（n = 37）。采用改良的McCormick量表（MMCS）评估临床结果。比较两组手术参数及并发症。结果：与背侧/外侧组相比，腹侧组患者矢状面肿瘤直径更大，椎管占用率更高(p)。结论：与背侧/外侧病变相比，腹侧胸椎IDEM脑膜瘤术前运动功能障碍更严重，术后神经功能恢复更差。这些发现强调了早期手术干预和量身定制的腹侧肿瘤手术计划的重要性，以优化功能结果。

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引用次数: 0

The effect of device-based neuromodulation on the motor recovery of patients with spinal cord injury 基于装置的神经调节对脊髓损伤患者运动恢复的影响。

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-10-26 DOI: 10.1038/s41393-025-01133-6

Jingchi Li, Tianshun Chen, Xuyan Yan, Lin Luo

This paper systematically analyzes literature from PubMed, MEDLINE, Embase, and Cochrane databases over the past 10 years (up to May 25, 2025). It employs defined search terms, inclusion/exclusion criteria, and a documented search flow to evaluate mechanisms, efficacy, challenges, and future directions of neuromodulation technologies for spinal cord injury rehabilitation. The results synthesize findings from clinical trials, and representative papers. This review aims to evaluate the mechanisms and clinical applications of device-based neuromodulation technologies in spinal cord injury (SCI) rehabilitation, focusing on their efficacy, challenges, and future directions. The countries and regions worldwide participating in neuromodulation. We systematically analyzed advancements in neuromodulation over the past decade, including brain-spinal interfaces (BSI), brain-computer interfaces (BCI), cranial stimulation techniques (DBS, TMS, tDCS), spinal cord stimulation (SCS), robotic exoskeletons. The review integrates findings from clinical trials. Neuromodulation technologies demonstrate significant potential in restoring motor and sensory function post-SCI. BSI and BCI improve mobility but face infection and cybersecurity risks. Cranial stimulation techniques enhance neuroplasticity, with DBS and TMS showing efficacy, while tDCS requires further validation. Epidural SCS enables motor recovery in complete paralysis but has high infection rates. Robotic exoskeletons benefit younger patients. Neuromodulation technologies represent promising interventions for SCI, yet challenges remain in precision, safety, and efficacy. Future research should prioritize AI-driven parameter optimization, wearable device development, and multicenter randomized trials to establish these methods as core treatments, ultimately improving patient outcomes and quality of life.

研究设计：本文系统分析了PubMed、MEDLINE、Embase和Cochrane数据库过去10年（截至2025年5月25日）的文献。它采用定义的搜索术语、纳入/排除标准和文档化的搜索流程来评估脊髓损伤康复的神经调节技术的机制、疗效、挑战和未来方向。结果综合了临床试验和代表性论文的结果。目的：综述基于器械的神经调节技术在脊髓损伤（SCI）康复中的作用机制和临床应用，重点讨论其疗效、挑战和未来发展方向。背景：世界范围内参与神经调节的国家和地区。方法：系统分析了近十年来神经调节的进展，包括脑脊髓接口（BSI）、脑机接口（BCI）、颅刺激技术（DBS、TMS、tDCS）、脊髓刺激（SCS）、机器人外骨骼。该综述整合了临床试验的结果。结果：神经调节技术在恢复脊髓损伤后的运动和感觉功能方面显示出巨大的潜力。BSI和BCI提高了移动性，但面临感染和网络安全风险。颅刺激技术增强神经可塑性，DBS和TMS显示出疗效，而tDCS有待进一步验证。硬膜外SCS可使完全瘫痪患者恢复运动功能，但其感染率较高。机器人外骨骼有利于年轻患者。结论：神经调节技术为脊髓损伤治疗提供了很有前景的干预措施，但在准确性、安全性和有效性方面仍存在挑战。未来的研究应优先考虑人工智能驱动的参数优化、可穿戴设备开发和多中心随机试验，以建立这些方法作为核心治疗方法，最终改善患者的预后和生活质量。

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引用次数: 0

Reply to the comment on "increased risk of osteoarthritis in persons with spinal cord injury: a population-based longitudinal follow-up study in Taiwan". 回复关于“台湾脊髓损伤患者骨关节炎风险增加：一项基于人群的纵向随访研究”的评论。

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-10-21 DOI: 10.1038/s41393-025-01128-3

Chien-Po Liu, Shin-Liang Pan

引用次数: 0

Pneumonia history and long-term impact on people with traumatic spinal cord injury: A 5-year cohort study 创伤性脊髓损伤患者的肺炎病史和长期影响：一项5年队列研究

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-10-21 DOI: 10.1038/s41393-025-01130-9

Yue Cao, Noelle Forcier, James S. Krause

Cohort study. To identify the self-reported pneumonia history since spinal cord injury (SCI) onset and the self-reported period prevalence of pneumonia in the past 12 months, and to investigate the relationship between a history of pneumonia (measured at time 1) and health conditions five years later (time 2). Medical University in the Southeastern United States. Participants (N = 768) met the following inclusion criteria: traumatic SCI of at least 1-year duration, minimum of 18 years of age, and residual impairment from SCI. Of these, 554 (72%) were successfully followed up, who comprised of our final sample. We used the Poisson regression model to examine the association between pneumonia history at time 1 with the self-reported health conditions at time 2. At time 1 measurement, 29% of participants reported pneumonia history since SCI onset. Among them, 14% had pneumonia once, and 15% experienced pneumonia more than once. After controlling for other independent variables, participants who reported multiple episodes of pneumonia at time 1 had a 22% higher likelihood of experiencing a health problem at time 2 than those without a pneumonia history. The repeated pneumonia history in the past is a significant predictor for future pneumonia episodes and other health conditions. It is important to prevent recurrent pneumonia to enhance both the longevity and quality of life for individuals with SCI.

研究设计：队列研究。目的：了解自脊髓损伤（SCI）发病以来的自我报告肺炎史和近12个月的自我报告肺炎流行情况，并探讨肺炎史（时间1）与5年后（时间2）健康状况的关系。地点：美国东南部医科大学。方法：参与者（N = 768）符合以下纳入标准：创伤性脊髓损伤持续时间至少1年，年龄至少18岁，脊髓损伤残留。其中，成功随访的554人（72%）构成了我们的最终样本。我们使用泊松回归模型来检验时间1的肺炎病史与时间2时自我报告的健康状况之间的关系。结果：在第一次测量时，29%的参与者报告了自脊髓损伤发病以来的肺炎史。其中，14%的人患过一次肺炎，15%的人不止一次患过肺炎。在控制了其他独立变量后，在第一次报告多次肺炎发作的参与者在第二次出现健康问题的可能性比没有肺炎病史的参与者高22%。结论：既往重复肺炎史是未来肺炎发作及其他健康状况的重要预测因子。预防复发性肺炎对于提高脊髓损伤患者的寿命和生活质量是非常重要的。

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引用次数: 0

Immediate supraphysiologic load bearing of the spine appears safe after gunshot-related spinal cord injury: a case-control study 一项病例对照研究表明，在枪击相关的脊髓损伤后，脊柱的即时超生理负荷似乎是安全的。

IF 2.2 4区医学 Q3 CLINICAL NEUROLOGY

Spinal cord

Pub Date : 2025-10-15 DOI: 10.1038/s41393-025-01129-2

Hirofumi Kusumoto, Isabel M. Alvarez, Dudley Fukunaga, Sean D. Dreyer, Kevin W. Rolfe

Retrospective case-control. To evaluate if early resistance training in the context of gunshot spinal cord injury is associated with neurologic decline or need for secondary surgery for a new neurological deficit or spinal deformity correction. A rehabilitation center in southern California. A retrospective review of 114 patients from a national spinal cord injury rehabilitation center was conducted. Patients were allocated to two groups: those who initiated resistance training exercises (e.g. free weight or weight machine exercises, resistance band exercises, or ergometer use on a resistance setting) within three weeks of date of injury and those who began after three weeks. Primary endpoints included change in American Spinal Injury Association (ASIA) grade and need for spinal surgery for any reason following resistance training exercises completed during the acute inpatient rehabilitation stay. Mean follow up interval was 2.5 ± 0.3 years for the entire study population. No patients sustained a neurologic decline or required secondary surgery for late deformity correction or any other reason regardless of time to resistance training initiation. There was no difference in ASIA grade improvement rates across either group. Immediate resistance training as part of a rehabilitation regimen for gunshot spinal cord injury appears safe.

研究设计：回顾性病例对照。目的：评估在枪弹脊髓损伤的情况下，早期阻力训练是否与神经功能下降或需要二次手术治疗新的神经功能缺损或脊柱畸形矫正有关。背景：南加州的一个康复中心。方法：对某国家级脊髓损伤康复中心收治的114例患者进行回顾性分析。患者被分为两组：一组在受伤后三周内开始进行阻力训练（如自由举重或举重机练习，阻力带练习，或在阻力设置下使用劳力计），另一组在三周后开始。主要终点包括美国脊髓损伤协会（ASIA）分级的变化，以及在急性住院康复期间完成阻力训练后因任何原因需要进行脊柱手术。结果：整个研究人群的平均随访时间为2.5±0.3年。无论阻力训练开始的时间长短，没有患者持续神经功能下降或因后期畸形矫正或任何其他原因需要二次手术。两组间亚洲分级改善率无差异。结论：立即抗阻训练作为枪伤脊髓损伤康复方案的一部分是安全的。

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