Abstract
The purposes of this study were to evaluate the incidence of pulmonary embolism (PE) by means of lung perfusion scinti-scan and assess the efficacy of a rehabilitation program to prevent PE in patients with SCI. In this prospective review of patients with SCI evaluated by lung perfusion scan, the participants were 16 patients with acute traumatic spinal cord injury who were treated in our institute from 2002 to 2003. All of these were assigned to the same rehabilitation program. The patients' ages at injury ranged from 41 to 83, mean 63.6 years. Levels of injures were cervical lesion in 11 patients, thoracolumbar lesion in 5 patients. Severity of palsy was classified as ASIA B in 3 cases, C in 11, and D in 2. 10 patients underwent spinal surgeries. Lung scinti-scan was performed within 3 weeks after injury and followed-up after 6 months. Findings of the lung perfusion scan were divided into four groups: a large defect in 0 cases, segmental defects in 9, small defects in 3, and normal in 4. Nine patients (56.3%) with segmental defects were diagnosed as having PE based on scinti-scan, and 5 of the 9 demonstrated hypoxycemia clinically. PE appeared not only in tetraplegic patients but also in some cases with central cord syndrome. These results suggest that SCI has a potential for high incidence of PE, and that the rehabilitation program was not sufficient to prevent PE.
