Diagnosis of Diabetic Spinal Cord Syndrome and Literature Review
糖尿病性脊髓综合征诊断学特征并文献复习

摘要

糖尿病引发中枢及周围神经系统损害最为常见，而以慢性进展的脊髓病变为主要表现的患者研究较少，这可能反映了糖尿病患者临床上明显的糖尿病性的脊髓损伤的罕见性。糖尿病脊髓损伤好发于颈椎，胸椎次之，腰椎最为少见。疾病进展缓慢且隐匿，常规规影像学评估通常诊断相对困难，仅MRI提示异常高信号，常因合并周围神经系统损害或原发脊髓损伤，而造成误诊或漏诊而延误治疗。因此临床实践中对此类患者也常因忽视病因而延误治疗，导致病情持续进展进而出现不可逆的脊髓损害。该病例较为少见，可为临床实践避免此类疾病的误诊和漏治提供一定帮助。

Abstract

Central and peripheral nervous system damage caused by diabetes is the most common,while there are few studies on patients with chronic progressive myelopathy, which may reflect the rarity of clinically obvious diabetes spinal cord injury in diabetes patients.This disease belongs to the central neuropathy of diabetes,accounting for only about 1.5% of the complications of diabetes nervous system,and can progress to myelopathy. Spinal cord injury in diabetes usually occurs in the cervical spine, followed by the thoracic spine and the lumbar spine.The progress of the disease is slow and hidden.Conventional imaging evaluation is usually relatively difficult to diagnose.Only MRI indicates abnormal high signal, which often leads to misdiagnosis or missed diagnosis and delayed treatment due to combined peripheral nervous system damage or primary spinal cord injury. Therefore,in clinical practice, the treatment of such patients is often delayed due to the neglect of the cause, resulting in the continuous progress of the disease and irreversible spinal cord damage.This case is relatively rare, which can provide some help for clinical practice to avoid misdiagnosis and missed treatment of this kind of disease.