PDF(Pubmed)
Abstract：
Traumatic spinal cord injury (SCI) is a devastating neurological disorder often accompanied by neuropathic pain (NeP), significantly affecting patients\' quality of life. This retrospective study aimed to investigate the impact of the time from injury to surgery on the development of NeP following traumatic SCI. Medical records of patients with traumatic SCI who underwent surgical intervention between January 2017 and January 2021 at two specialized centers were reviewed. Variables associated with NeP including demographics, injury profiles, medical history, surgical details, and pain assessments were investigated. Independent risk factors related to NeP were identified using multivariate logistic regression analysis. A total of 320 patients met the inclusion criteria, with 245 (76.6%) being male and a mean age of 56.5 ± 13.2 years. NeP was identified in 48.4% of patients (155 of 320). The multivariate analysis identifies age at injury, Injury Severity Score, and the neurological level of injury as independent risk factors for the development of NeP in both AIS A and AIS B, C, and D subgroups. Additionally, a significant association between the time from injury to surgery and NeP was observed in AIS B, C, and D patients, while no such association was found in AIS A patients. This study highlights the benefits of early and ultra-early surgical intervention in preventing NeP in patients with incomplete traumatic SCI (AIS B, C, and D), underscoring the importance of optimizing surgical timing to improve patient outcomes. Prospective studies are warranted to establish evidence-based surgical guidelines for managing traumatic SCI and preventing NeP effectively.
摘要：
创伤性脊髓损伤（SCI）是一种破坏性的神经系统疾病，通常伴有神经性疼痛（NeP）。显著影响患者的生活质量。这项回顾性研究旨在研究从损伤到手术的时间对创伤性SCI后NeP发展的影响。回顾了2017年1月至2021年1月在两个专业中心接受手术干预的创伤性SCI患者的病历。与NeP相关的变量，包括人口统计，损伤概况,病史,手术细节,和疼痛评估进行了调查。采用多因素logistic回归分析确定与NeP相关的独立危险因素。共有320例患者符合纳入标准，男性245人（76.6％），平均年龄56.5±13.2岁。在48.4％的患者中发现NeP（320例中的155例）。多变量分析确定受伤年龄，伤害严重程度评分,神经损伤水平是AISA和AISB中NeP发展的独立危险因素，C,和D子组。此外,在AISB中观察到从损伤到手术的时间与NeP之间的显着关联，C,D病人,而在AISA患者中没有发现这种关联。这项研究强调了早期和超早期手术干预在预防不完全创伤性SCI患者NeP方面的益处（AISB，C,andD),强调优化手术时机以改善患者预后的重要性。有必要进行前瞻性研究，以建立基于证据的手术指南，以有效地管理创伤性SCI和预防NeP。
