What Is Diplegia?

Paraplegia is a type of paralysis. Paraplegia caused by transverse lesions above the cervical spinal cord enlargement is high paraplegia, and paraplegia caused by spinal cord injury below the third thoracic spine is bilateral lower limb paraplegia. In the acute phase of spinal cord injury, bilateral limb sensations, movements, reflexes, etc. below the injury plane disappeared, as well as loss of bladder and anal sphincter function, resulting in spinal shock. Except for the surgical treatment of spinal cord injury in modern western medicine, there is no ideal treatment for this disease.

Basic Information

English name

paraplegia

Visiting department

Neurology

Common locations

Lower limbs and lower torso

Common causes

Spinal compression fractures, spinal cord injuries, transverse myelitis, spinal tumors, vertebral tuberculosis and syringomyelia

Common symptoms

Severe or complete loss of motor function in lower limbs and lower trunk

Causes of paraplegia and common diseases

Compression fractures of the spine, spinal cord injury, transverse myelitis, spinal tumors, vertebral tuberculosis, and syringomyelia are common causes of paraplegia.

Trauma

Spinal fractures or fractures-Dislocation injuries to the spinal cord or cauda equina, nerve damage.

2. Tuberculosis

The original history of spinal tuberculosis or symptoms of tuberculosis, most of the lesions occurred in the thoracic or cervical spine. The course of the disease is slow, mostly manifested as spastic paralysis, weakness or stiffness in the extremities or both lower limbs, stiffening of the affected area, kyphosis or scoliosis, the spinous process gap is not widened, X-ray films show vertebral osteolytic damage The intervertebral space narrows or disappears, and the vertebral bodies can be embedded with each other, and there are shadows of abscesses near the vertebrae. ESR increased faster.

3. tumor

It is more common in vertebral hemangiomas, vertebral giant cell tumors, and metastatic tumors . Vertebral hemangioma is more common in older women and occurs in single or multiple vertebral bodies in the thoracolumbar region. Early symptoms are local dull pain or girdle pain, paresthesia, and a slow course of disease. X-ray films show that the vertebrae are thickened bones arranged longitudinally, with stripe-shaped areas of reduced density between them, showing a fence-like or polycystic compression. Giant cell tumors of the vertebral body are more common in young and middle-aged people. At the initial stage, there are intermittent intermittent pains. Local tenderness and limited movement gradually cause paraplegia. X-ray films showed soap bubbles or osteolytic changes in the vertebral body and incomplete trabecular bone. Paraplegia caused by metastases has a history of primary tumor treatment. Paraplegia symptoms gradually appear, and the course of disease is slow. X-ray films show vertebral body looseness, consistent compression before and after, osteolytic or worm-like destruction, osteogenic spots and massive sclerosis, or mixed images of osteogenic and lytic types. The upper and lower vertebral spaces are generally not significantly changed.

4. Genetic Metabolic Disease

Hereditary spastic paraplegia.

Differential diagnosis of paraplegia

Lumbar disc herniation

More common in men aged 20 to 40, low back pain and sciatica, and pain worsens when coughing. Examination showed lumbar scoliosis, physiological lordosis was reduced or disappeared, and the ipsilateral straight leg elevation test was positive, but the patient's erythrocyte sedimentation and body temperature were normal.

2. Suppurative inflammation of the spine

Before the onset, patients often had bloated skin or other suppurative foci, and the disease often started suddenly, with high body temperature, obvious symptoms of poisoning, obvious pain in the affected area, limited movement, local soft tissue swelling and tenderness. X-rays show bone destruction, intervertebral narrowing, dead bone formation, and abscess-free formation. Bacterial and histological examination should be performed to confirm the diagnosis.

3. Spontaneous ring and axis dislocation

Often secondary to inflammation of the pharynx. Children under the age of 10 often support the mandible with hands, with torticollis, limited neck movement, X-ray radiographic dislocation of the ring vertebra, dentate process shifted to the side or rear, no bone damage, no cold Abscess shadow. A CT test is helpful for diagnosis.

Paraplegic examination

Laboratory inspection

Necessary and selective items include: blood routine, urine routine, blood electrolytes, blood glucose, biochemical examination, liver function, urea nitrogen, and kidney function.

2. Auxiliary inspection

The necessary selective items include:

(1) Cranial imaging, CT and MRI examination.

(2) Cerebrospinal fluid examination.

(3) chest radiograph, electrocardiogram, and ultrasound.

Principles of paraplegia treatment

Treatment for the cause.

Physical therapy

Mainly to improve the movement of various joints throughout the body and residual muscle strengthening training, as well as balance and coordinate movements and position exchange and transfer movements (such as lying to sitting, turning over, from bed to wheelchair), and physical therapy.

2. Occupational Therapy

Mainly daily activities (such as basic skills of clothing, food, housing, travel), occupational labor movements, craft labor, so that patients can adapt to the needs of personal life, family life, social life and labor after discharge.

3. Psychotherapy

Develop a psychological treatment plan for changes in different psychological stages (such as denial, anger, depression, etc.), which can be performed in a variety of ways, including individual, family, and behavior.

4. Rehabilitation Engineering

Some necessary braces can be customized to practice standing and walking, and some special tools such as walkers can also be equipped to compensate for the lack of functions.

5. Clinical rehabilitation

Application of nursing and drug means to prevent the occurrence of various complications, reduce symptoms and promote functional recovery.