Survey of Spinal Cord Injuries Due to Diving Accidents in Taiwan
塗雅雯(Ya-Wen Tu)；梁惠雯(Huey-Wen Liang)；王顏和(Yen-Ho Wang)；康峻宏(Jiunn-Horng Kang)；畢柳鶯(Liu-Ing Bih)；鄧復旦(Fuk-Tan Tang)
跳水意外 ； 脊髓損傷 ； 台灣 ； diving accidents ； spinal cord injury ； Taiwan
|Volume or Term/Year and Month of Publication||
34卷1期（2006 / 03 / 01）
11 - 17
近來台灣跳水運動逐年盛行，常造成頸椎嚴重及持久性的傷害。國外相關發表之研究報告眾多，而國內對於跳水造成脊髓損傷之調查研究並不完整，因此本研究之目的在於探討台灣地區跳水造成脊髓損傷之臨床表現與型態分佈。 本研究收集了台灣大學醫學院附設醫院、林口長庚紀念醫院、中山醫學大學附設醫院自1982年至2002年期間因脊髓損傷的病例，共計1216例。其中16例因跳水造成脊髓損傷，占1.3%。平均年齡26.8歲。15例(94.0%)是男性。意外皆發生於夏季。大部分(63.0%)發生在無人監視的開放水域。所有病例皆造成頸椎受傷導致四肢癱瘓，最常發生脊椎骨受傷部位為C5 (50.0%)，其次為C4與C6。神經學上，C5為最常發生之脊髓損傷部位。沒有人併發其他部位之受傷。75.0%之病患接受外科手術治療。而37.5%之患者有神經學上之恢復，大部分見於不完全性之脊髓損傷患者。相較於國外研究，台灣地區因跳水造成脊髓損傷之比例偏低，探討原因，可能與國內跳水風氣較不盛行，反而與較多車禍與意外跌落之病例有關。其臨床表現與型態分佈與國外報告相似。鑒於頸椎脊髓損傷所造成傷害之永久性與廣泛性，應加強傷害防範措施與教育。
Objective: To examine the clinical characteristics of diving-related spinal cord injuries (SCI) in Taiwan. Methods: This study is a retrospective review of all hospitalized patients with spinal cord injuries due to diving accidents in three rehabilitation centers between January 1982 and July 2002. Demographic data and clinical features were presented and analyzed. Results: A total of 1216 spinal cord injuries were reviewed, and 16 cases (1.3%) met the inclusion criteria. Their mean age at the time of injury was 26.8 years and 15 (94.0%) of the cases were male. All of the injuries resulted in tetraplegia and 11 (69.0%) were neurologically complete. The most commonly neurological level was C5. The most common vertebral injury level was C5 (50.0%), followed by C4 and C6. All of the injuries occurred during summer and 63.0% occurred in the open water. Associated injuries were rare. A total of 75.0% of the patients underwent surgical treatment and neurological recovery was observed in 37.5% of these cases, of which most were incomplete injuries. Discussion and Conclusions: The proportion of diving-related spinal cord injuries in our study was lower than most of the previous reports. A higher percentage of traffic accidents and accidental falls, and a reduced popularity of water sports are possible reasons. We observed some typical features of SCI due to diving accidents in our study. Most of the diving accidents occurred among young males, and resulted in mid-cervical injuries with complete tetraplegia. Our results show that injury-preventing strategies need to be emphasized.