外伤患者中,脊髓损伤的发生率为6%。[8]Parsons KC. The impact of spinal cord injury on long-term survival. J Insur Med. 1991 Winter;23(4):227.http://www.ncbi.nlm.nih.gov/pubmed/10148505?tool=bestpractice.com 男性患者和女性患者的比例是 4:1,[8]Parsons KC. The impact of spinal cord injury on long-term survival. J Insur Med. 1991 Winter;23(4):227.http://www.ncbi.nlm.nih.gov/pubmed/10148505?tool=bestpractice.com 中位年龄是 25 岁(但年长者也会因患有骨质疏松症,在轻微摔伤时造成胸腰段椎体骨折)。因脊髓损伤入院的儿科患者占 1% 至 5%。[9]Hamilton MG, Myles ST. Pediatric spinal injury: review of 174 hospital admissions. J Neurosurg. 1992;77:700-704.http://www.ncbi.nlm.nih.gov/pubmed/1403110?tool=bestpractice.com 儿科患者群体中,椎体无骨折也会造成脊髓损伤,这种情况称为 SCIWORA(无影像学异常的脊髓损伤)。 SCIWORA 在 9 岁以下患儿中的发病率为 42%,在 15 至 17 岁患者中的发病率为 8%。[10]Dickman CA, Zabramski JM, Hadley MN, et al. Pediatric spinal cord injury without radiographic abnormalities: report of 26 cases and review of the literature. J Spinal Disord. 1991;4:296-305.http://www.ncbi.nlm.nih.gov/pubmed/1802160?tool=bestpractice.com
胸腰段椎体骨折在全部脊髓损伤中占30%至60%,T11和L2之间的脊椎最常发生骨折(60%)。 多节段脊柱骨折在脊髓损伤患者中占15%至20%。[11]Vaccaro AR, An HS, Lin S, et al. Noncontiguous injuries of the spine. J Spinal Disord. 1992 Sep;5(3):320-9.http://www.ncbi.nlm.nih.gov/pubmed/1520991?tool=bestpractice.com 大部分孤立性骨折与骨质疏松症有关。[12]Riggs BL, Melton LJ. Osteoporosis: etiology, diagnosis, and management. Philadelphia, PA: Lippincott-Raven; 1995.
[Figure caption and citation for the preceding image starts]: 腰椎磁共振成像:矢状位(T2加权序列)显示T12椎体有骨质疏松性骨折来自B. Nurboja博士和D. Choi先生个人收集的资料 [Citation ends].
大约50%的脊髓损伤患者会出现相关神经系统损伤。[13]Riggins RS, Kraus JF. The risk of neurologic damage with fractures of the vertebrae. J Trauma. 1977;17:126-133.http://www.ncbi.nlm.nih.gov/pubmed/846019?tool=bestpractice.com 在所有病例中,胸椎脊髓损伤占17%,腰椎脊髓损伤占20%-24%。[14]Tator CH, Duncan EG, Edmonds VE, et al. Neurological recovery, mortality and length of stay after acute spinal cord injury associated with changes in management. Paraplegia. 1995;33:254-262.http://www.ncbi.nlm.nih.gov/pubmed/7630650?tool=bestpractice.com 这些类型的伤者通常还带有其他损伤,如多系统损伤(80%)[11]Vaccaro AR, An HS, Lin S, et al. Noncontiguous injuries of the spine. J Spinal Disord. 1992 Sep;5(3):320-9.http://www.ncbi.nlm.nih.gov/pubmed/1520991?tool=bestpractice.com 和头部损伤 (41%)。[15]Davidoff G, Roth E, Morris J, et al. Assessment of closed head injury in trauma related spinal cord injury. Paraplegia. 1986 Apr;24(2):97-104.http://www.ncbi.nlm.nih.gov/pubmed/3714296?tool=bestpractice.com
在美国,每个伤者接受短期或长期脊髓损伤治疗的医疗费用约为 63 万美元至 97 万美元。 四肢瘫痪占脊髓损伤病例的 10%,而其医疗费用占脊髓损伤医疗费用的 80%。 不完全损伤医疗费用占直接费用的15%,截瘫的医疗费用占该类费用的4%。[16]DeVivo MJ. Causes and costs of spinal cord injury in the United States. Spinal Cord. 1997;35:809-813.http://www.ncbi.nlm.nih.gov/pubmed/9429259?tool=bestpractice.com