Travmatik Omurilik Yaralanmalı Hastalarda Ağrı
2 Serbest hekim, Bursa
3 Uludağ Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Bursa
4 Uludağ Üniversitesi Tıp Fakültesi, Fizik Tedavi ve Rehabilitasyon Anabilim Dalı, Bursa
Aim of the Study: As the developments in the treatment and care of the patients with Traumatic Spinal Cord Injury (TSCI) improved the quality and the duration of life, pain appeared to be a major problem in this population. The number of publications on the clinical and functional importance of pain in TSCI is limited. Thepurpose of this study is to define pain and related characteristics in TSCI patients.
Methods: Sixty patients who were admitted to the deparment of Physical Medicine & Rehabilitation of Uludağ University Medical School were included in this study. Data on pain were collected from the TSCI record forms. Patieents were classified into four groups according to the injury levels; Group 1: C1 and C8, Group 2: Th1 and Th6, Group 3: Th7 and L1 and Group 4: L2 and below. frankel classification was used for the evaluation of functional status. Data were analyzed using Chi-Square test. Results: Mean age of the patiens was 33+15 years with a range of 10 and 70 (46 male (77%); 14 female (23%).) Distribution according to the spinal cord injury level was as follows; Group 1: 17 patients (27%), Group 2: 5 patients (10%), Group 3: 2 patients (40%) and Group 4: 14 patients (23%). According to the Frankel Calssification; 23 patients were in class A (38%), 4 were in class B (7%), 15 were in class C (25%) and 18 were in class D (30%). Twenty-three lesions were evaluated as complete (38%), 4 were in class B (7%), 15 were in class C (25%) and 18 were in class D (30%). Twenty-three lesions were evaluated as complete (38%) and 37 as incomplete (62%). Mean duration of disease was 19 27 months and the mean duration of follow-up was 6+4 months. Pain was present in 29 patients (48%). Twelwe patients had dysesthetic pain (20%), 8 had mechanical pain (13%), 6 had visceral pain (10%) and three had radicular pain (5%). Dysesthetic pain was the commonest (41%) and statistically significantly greater in thoracolumbar level injuries (Group 3) than the other levels (p<0.05). Two of the pain (espacially shoulder) and two had lower extreemity pain. Visceral pain (21%) was originated from gastrointestinal system in all cases. Ten percent of the pain cases were due to radicular pain.
Conclusion: Our results indicated that the dysesthetic pain was the commonest type of pain and well-designed prospective studies are needed.
Keywords : Traumatic Spinal Cord Injury, complications, pain, dysesthetic pai