创伤性脊柱损伤

A traumatic spine injury means the spine has been damaged by a sudden event (like a fall, car crash, sports or violence), sometimes breaking bones and sometimes injuring the spinal cord and nerves inside. The seriousness ranges from painful but stable injuries to emergencies that can cause paralysis and breathing or bladder problems.​

1) What is this condition?

  • A sudden force damages one or more spinal bones, joints, discs, ligaments, and sometimes the spinal cord and nerve roots that run through the spine.​

  • The injury can occur anywhere from the neck to the low back, with neck injuries more likely to affect arms and breathing, and mid‑/low‑back injuries more likely to affect legs and bladder/bowel.​

2) How serious is it?

  • Warning signs include severe neck or back pain, weakness, numbness, loss of feeling, trouble walking, loss of bladder/bowel control, or trouble breathing after an accident.​

  • If the spinal cord is damaged, there can be partial or complete loss of movement and feeling below the injury; this can be life‑changing and sometimes life‑threatening.​

3) Non‑surgical treatments

  • Emergency care: careful spine protection (neck collar, backboard), blood pressure support, and intensive monitoring to prevent further damage.​

  • Medicines to manage blood pressure, pain, and complications; high‑dose steroids are less commonly used now but may be considered in some centers early after injury.​

  • Bracing or traction in selected fractures to keep the spine aligned while it heals, if the injury is stable enough to avoid surgery.​

  • Early, structured rehabilitation (physical and occupational therapy) to maintain joint motion, prevent sores and clots, and begin retraining movement and self‑care.​

4) Types of surgery that may be necessary

  • Decompression surgery: removing bone, disc, or other tissue pressing on the spinal cord or nerves.​

  • Fusion with hardware: placing screws, rods, and bone graft to realign and stabilize broken or dislocated vertebrae so they no longer shift dangerously.​

  • Surgery may be done from the front, back, or both sides of the spine, depending on the injury location and pattern.​

5) Goals of surgery vs non‑surgical care

  • Non‑surgical goals:

    • Protect the injured spine, avoid further movement, support breathing and blood pressure, and treat complications while the injury and overall condition stabilize.​

    • Allow bone and soft tissues to heal in good alignment when the injury is stable enough to be treated with braces and rehab alone.​

  • Surgery goals:

    • Quickly relieve pressure on the spinal cord and nerves to give them the best chance to recover.​

    • Restore and maintain proper alignment and stability of the spine to prevent further damage and allow early safe mobilization.​

6) How surgery can “fix” the problem

  • Decompression removes fragments of bone, disc, or ligament that are pinching the spinal cord or nerves, giving them more room and better blood flow.​

  • Screws and rods secure stable vertebrae above and below the injury and are connected to hold the spine straight while bone grafts help the segment fuse into a solid block.​

  • When done early (especially within 8–24 hours), decompression and stabilization can shorten hospital stay, lower complication risk, and may improve nerve recovery in some patients.​

7) Risks of surgery (general and specific)

  • General risks: infection, bleeding, blood clots, lung or heart problems, and complications from anesthesia, especially in severely injured patients.​

  • Spine‑ and cord‑specific risks:

    • Worsening of weakness, numbness, or paralysis if the spinal cord or nerves are further injured during surgery.​

    • Hardware failure (loosening or breakage) or failure of the bones to fuse, sometimes needing more surgery.​

8) Chances this surgery will work

  • Early decompression (within about 24 hours, and especially within 8–12 hours) is linked to fewer complications, shorter hospital stays, and better neurologic recovery in some studies.​

  • Surgery is usually effective at stabilizing the spine and preventing further mechanical damage; how much nerve function returns depends heavily on how severe the first (primary) injury was.​

9) Possible complications from the surgery

  • Wound infections, fluid collections, or poor healing, which are more common in long, complex operations and those with multiple injuries.​

  • Persistent pain, stiffness, or deformity despite a technically successful fusion.​

  • Medical complications such as pneumonia, blood clots, pressure sores, and urinary infections are common after severe spine injuries and require aggressive prevention.​

10) Typical recovery from the condition

  • Recovery is often long and occurs in stages: days in intensive care, then weeks to months in hospital and rehab, and then ongoing outpatient therapy.​

  • People with incomplete spinal cord injuries (some movement or feeling below the injury) have better chances of regaining walking and independence than those with complete injuries.​

  • Even when the cord is not injured, bone and soft‑tissue healing plus muscle re‑conditioning can take many months.​

11) Typical recovery after surgery

  • First days: intensive monitoring, pain control, prevention of complications, and very early assisted sitting or standing if safe.​

  • Weeks: structured inpatient or early outpatient rehab focusing on transfers, wheelchair skills or walking, self‑care, and strengthening.​

  • Months to years: continued therapy, adaptive equipment, and sometimes home or workplace modifications; neurologic recovery (if any) tends to be fastest in the first 6–12 months but can continue more slowly after that.​

12) How long in the hospital

  • Uncomplicated, stable spine fractures without cord damage may need only several days of hospital care.​

  • Moderate to severe spinal cord injuries often require weeks in acute care, followed by weeks to months in a rehabilitation facility.​

13) Long‑term outlook

  • Some people with milder injuries recover fully or nearly fully and return to work and driving.​

  • Others live with partial or complete paralysis and may need wheelchairs, personal care assistance, and long‑term medical follow‑up, but many still achieve meaningful independence with rehab and adaptive technology.​

  • Long‑term issues can include chronic pain, spasticity, bladder/bowel and sexual changes, and mood challenges, all of which can be addressed with specialized care.​

14) Need for outpatient follow‑up

  • Regular follow‑up with spine surgeons, rehab doctors, and therapists to monitor bone healing, hardware, alignment, and neurologic status.​

  • Long‑term rehab, including physical, occupational, and sometimes speech therapy, plus psychological support and vocational counseling.​

  • Ongoing primary and specialty care to prevent and manage late complications such as osteoporosis, pressure sores, urinary problems, and cardiovascular risks.