척추 압박성 척수증 환자에서 대소변 장해 = Bladder and Bowel Dysfunction in Patients with Spinal Compressive Myelopathy

국문 초록 (Abstract)

연구 계획: 후향적 분석목적: 척추 압박성 척수증에서 대소변 장해의 빈도와 특성을 확인해 보고자 하였다.
선행 연구문헌의 요약: 척추 압박성 척수증에서 대소변 장해는 흔히 동반되나 이와 관련된 신경학적 증상과 대소변 장해에 관련성을 분석한 연구는 드문실정이다.
대상 및 방법: 483명의 척추 압박성 척수증 환자를 대상으로 하였다. 경추 척수증이 383예이었고, 흉추 척수증이 100이었다. 평균 연령은 60.73세이었고 평균 이환 기간은 7.82개월이었다. 임상적으로 나이, 성별, 이환 분절의 수, 주요 증상 부위(상지, 하지, 동시), 이환 기간, 임상적 결과를 분석하였고, 대소변 장해 여부에 따라 비교, 분석하였다.
결과: 56예(11%)의 환자에서 대소변 장해 증상을 보였다. 배뇨 장해는 32 례에서 보였고, 배변 장해 환자는 5명이었으며 19명은 대소변 장해 증상을 모두 보였다. 대소변 장해 여부에 대하여 나이(p=0.811), 성별(p=0.239), 이환 분절의 수(p=0.902) 간 차이는 없었다. 흉추 척수증 환자(22%)에서 경추 척수증(8%)에 비하여 많은 대소변 장해를 보였다(p=0.001). 주요 임상 증상에 따른 분석에서는 하지 증상(20%)과 상하지 동시 증상(10%) 환자에서 상지 주요증상 환자(2%)에 비하여 의미 있게 많은 대소변 장해를 보였다(p<0.001).
결론: 척추 압박성 척수증에서 대소변 장해는 흉추 척수증과 하지 주요 증상 환자에서 더 흔히 발생하였다. 임상적 결과는 경추 병변에서 흉추에 비하여양호하였다.

다국어 초록 (Multilingual Abstract)

Study Design: Retrospective case analysis Objectives: The purpose of this study was to examine the prevalence and characteristics of bladder and bowel disturbance (BBD) in patients with spinal compressive myelopathy.
Summary of Literature Review: Spinal compressive myelopathy is often associated with BBD. However, few studies have investigated the relationship between neurological evaluation and BBD findings.
Materials and Methods: We evaluated 483 spinal compressive myelopathy patients. Cervical myelopathy was present in 383 cases and thoracic myelopathy in 100 cases. Patients’ mean age was 60.73 years. The mean duration of symptoms was 7.82 months. The clinical characteristics of age, sex, number of involved segments, main symptoms (upper extremity, lower extremity, combined), duration of symptoms, and clinical outcomes were evaluated and compared according to the presence or absence of BBD.
Results: Fifty-six patients had BBD (11%). Bladder dysfunction was present in 32 patients, and bowel dysfunction was observed in 5 patients. Nineteen patients showed both symptoms. There were no significant differences in age (p=0.811), sex (p=0.239), or the number of involved segments (p=0.902) between the BBD and non BBD group. Patients with thoracic myelopathy more frequently exhibited BBD (BBD vs. non BBD: 22 vs. 78) than those with cervical myelopathy (34 vs. 349) (p=0.001). Patients with lower extremity symptoms (20%) and symptoms in both extremities (10%) more frequently showed BBD than those with upper extremity symptoms (2%) (p<0.001).
Conclusions: BBD was more common in patients with thoracic myelopathy and those whose main symptoms were in the lower extremity. Clinical outcomes were better in cervical cases than in thoracic cases.

참고문헌 (Reference)

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