摘要
脊髓损伤是一种严重的中枢神经系统疾病,常导致损伤平面以下的肢体感觉运动障碍,并伴有呼吸功能衰竭、肠道功能及血流动力学紊乱。现有治疗方法中,早期减压手术和激素类药物冲击疗法效果欠佳且易引发多种严重并发症,与此同时,康复治疗费用高昂且仅能获得有限功能恢复。脊髓电刺激(SCS)通过刺激调控残存的低位脊髓中间神经元,重塑残存神经传导束功能,可有效促进脊髓损伤患者运动功能修复。脊柱外科引入智能精准辅助技术,针对脊髓损伤不同程度、节段及病程来制订更加精准、个体化的神经调控和康复策略,结合实时反馈,不断修正算法,实现对SCS的远程安全调控,提高脊髓损伤患者救治的有效性及安全性,有助于制订更为有效的康复干预方案,进一步提高临床转化价值。笔者就智能精准辅助技术在SCS治疗脊髓损伤中应用的研究进展进行综述,为脊髓损伤的康复治疗提供参考。
Spinal cord injury is a severe central nervous system disorder that often results in sensory and motor impairments below the level of injury,accompanied by respiratory failure,gastrointestinal disturbances,and hemodynamic instability.Existing treatment such as early decompression surgery and steroid‑based shock therapy has limited effectiveness and can lead to serious complications.Meanwhile,the rehabilitation therapy is costly and can only provide limited functional recovery.Spinal cord stimulation(SCS),by stimulating and regulating residual neurons in the lower spinal cord,can effectively promote motor function recovery in patients with spinal cord injury.The introduction of intelligent precision‑assistive technologies can help to create more precise and individualized neuro‑regulation and rehabilitation strategies tailored to the severity,segment,and course of spinal cord injury.These strategies,coupled with real‑time feedback and continuous algorithm adjustments,enabled remote and secure control of SCS,enhancing the treatment effectiveness and safety for patients with spinal cord injury,which can help to develop more effective rehabilitation intervention plans and further increase the clinical translational value.In this review,the authors summarized the research progress in the application of intelligent precision‑assistive technology in SCS for the treatment of spinal cord injury,so as to provide valuable insights for the rehabilitation of SCI.
作者
周密
钟昊
柳松
邢琮
宁广智
Zhou Mi;Zhong Hao;Liu Song;Xing Cong;Ning Guangzhi(Department of Orthopedics,Tianjin Medical University General Hospital,Tianjin 300052,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2023年第9期857-864,共8页
Chinese Journal of Trauma
基金
国家自然科学基金(82272470)
天津市卫生健康科技项目(TJWJ2022XK011)
京津冀基础研究合作专项(20JCZXJC00080)。
关键词
脊髓损伤
电刺激疗法
人工智能
治疗
计算机辅助
Spinal cord injuries
Electric stimulation therapy
Artificial intelligence
Therapy,computer‑assisted
