Paraplegic
Introduction
Introduction Paraplegia is caused by direct manipulation (such as firearms, knife stab wounds, etc.) and indirect manipulation (spine fractures, dislocations, etc.). Spinal manipulation can affect the gradual atrophy of muscles, loss of related sensations and perceptions, impaired function of certain organs (such as bladder loss, etc.) or loss of certain mobility, and serious life-threatening. Therefore, traumatic paraplegics should actively carry out early rescue and reasonable treatment, combined with the doctor's rehabilitation guidance, strengthen nursing work, strive for spinal fractures, dislocation to achieve reduction and maximum recovery of spinal cord function in the early stage.
Cause
Cause
1, traumatic type: mostly caused by spinal trauma, fractures and spinal cord injury.
2, spinal cord compression type: bone hyperplasia caused by bone hyperplasia, spinal stenosis, disc herniation surgery injury.
3, spinal degeneration type: including spinal cord softening, cavities, atrophy caused by inflammation and compression-type transformation.
4, paraplegia caused by tuberculosis: the history of the original spinal tuberculosis or tuberculosis poisoning symptoms, lesions mostly occur in the thoracic or cervical vertebrae. The course of the disease is slow, and it is often characterized by spastic paralysis. The limbs or lower limbs are weak, hard and stiff, and the affected area may have kyphosis or lateral deformity. The spinous process gap is not widened. X-ray films show that the vertebral body has osteolytic damage. The intervertebral space is narrowed or disappeared, and the vertebral bodies may have mutual embedding, and there is an abscess shadow on the paravertebral. ESR increased.
Examine
an examination
Grade I: The patient walked normally, consciously had strong lower limbs, checked with or without clonic, and his pathological reflex was positive.
Grade II: The muscles are tense, weak, and uncoordinated when the patient walks. Need or need to be able to walk, check the limbs for sputum and sputum.
Level III: The lower extremity muscles are unable to walk and the patient is forced to stay in bed. The examination showed a straight paraplegia, and about 50% of the cases were perceptually impaired.
Grade IV: Patients with flexion-type paraplegia, more than 50% of patients with sensory disturbances, often with acne, or more sphincter dysfunction, including soft palate.
Diagnosis
Differential diagnosis
Paraplegia symptoms need to be identified as follows.
(1) Degenerative disc disease is about 40 years old, especially physical laborers. It is common in cervical vertebrae and lumbar vertebrae. The edges of adjacent vertebral bodies are dense, or there is lip-like hyperplasia. There is no enlarged shadow on the paravertebral, and the patient's body temperature and erythrocyte sedimentation rate are normal.
(B) Congenital vertebral deformity is more common in 16 to 18 years old, low back pain, appearance or scoliosis and other deformities. X-ray film can be seen in the vertebral body, vertebral body wedge shape or adjacent vertebral body fusion or ribs and other deformities, the number of pedicle transverse processes and ribs on both sides, such congenital malformations should be treated with curative Identification of body tuberculosis.
(C) lumbar disc herniation is more common in men aged 20 to 40 years, low back pain and sciatica, pain increased when coughing. Examination showed visible lumbar curvature, physiological lordosis decreased or disappeared, the affected side straight leg elevation test was positive but the patient's erythrocyte sedimentation rate and body temperature were normal. Lumbar vertebrae 4 ~ 5 or lumbar vertebrae 5 1 tuberculosis posterior lesions are often confused.
(D) Before the onset of suppurative inflammation of the spine, the patient often had skin edema or other septic lesions, and the body temperature was high, the symptoms of poisoning were obvious, the pain in the affected part was obvious, the activity was limited, and the local soft tissue was swollen and tender. X-ray film vertebral body visible bone destruction, narrowing of the intervertebral space, often with dead bone formation, and no abscess formation, should be diagnosed by bacteria and histology.
