摘要目的:探讨儿童非严重暴力所致无骨折脱位型脊髓损伤的原因、诊断、治疗和预后，提高对儿童脊髓损伤的认识。方法:回顾性分析我院2015年8月至2020年9月收治的非严重暴力所致无骨折脱位型脊髓损伤患儿的发病年龄、致伤机制、临床主要症状及出现时间、治疗过程及恢复情况、分析急性期脊髓MRI表现，并电话随访长期预后。依照美国脊髓损伤协会制定的标准判断脊髓损伤程度。结果:共6例患儿，男3例，女3例，年龄16个月~8岁。致伤机制：床上跌落，直立位臀部着力跌坐，体育运动用力跳跃跌倒。外伤后立即出现症状。主要症状：双下肢无力、疼痛，不能行走，排尿障碍。治疗过程：脊柱制动，尽早甲泼尼龙冲击治疗[20 mg/(kg·d)]，减轻水肿、营养神经等治疗，必要的对症治疗包括导尿、抗感染，及时康复治疗。6例患儿脊髓放射性检查未见骨折及脱位，脊髓MRI提示胸髓及胸髓以下异常信号。脊髓功能恢复顺序：小便功能恢复，下肢疼痛减轻，下肢无力改善。电话随访时病程1~5年，1例二便失禁、肌力Ⅰ级，脊髓MRI提示萎缩性改变；余5例可独立行走，长距离行走诉腿痛，有轻度足内翻或外翻，脊髓MRI无明显异常。结论:日常活动中，除跳舞下腰外，骶尾部着地跌倒易致儿童无骨折脱位型脊髓损伤，脊髓功能常不能完全康复，部分患儿不能恢复，宜早期识别，及时制定综合治疗措施，努力改善预后。

abstractsObjective:To investigate the causes, diagnosis, treatment and prognosis of children with spinal cord injury without radiologic abnormality caused by non-severe violence, and to raise the awareness of spinal cord injury in children.Methods:Retrospective analysis was performed on the age of onset, injury mechanism, main clinical symptoms and occurrence time, treatment process and recovery of children with spinal cord injury without radiologic abnormality caused by non-severe violence. The children were admitted to our hospital from August 2015 to September 2020. Abnormal findings in spinal cord MRI in acute stage were analyzed, and long-term prognosis was followed up by telephone. The degree of spinal cord injury was determined according to the criteria established by the American Spinal Cord Injury Association.Results:Of six patients, three boys and three girls, aged from 16 months to 8 years old.Injury mechanism: fall on the bed, a sudden fall in standing position, fall while jumping in sports.All of the symptoms appeared immediately after trauma, such as limb weakness, pain, unable to walk, urination disorders.Treatment process: spinal immobilization, methylprednisolone pulse therapy[20 mg/(kg·d)], alleviat edema and protect the nerve system, necessary symptomatic treatment including urethral catheterization, the use of antibiotics, timely rehabilitation treatment.No fracture or dislocation was found in all six patients by spinal cord radiometric examination, and MRI of spinal cord indicated abnormal signals of thoracic cord or below. The recovery sequence of spinal cord function: urination function recovery, pain from lower limbs relief, lower limbs weakness improvement.By the time of follow-up by telephone, the course of disease was 1 to 5 years. Urine fecal incontinence was found in one patient, and his muscle strength of both lower extremities belong to grade Ⅰ, atrophic changes were found in spinal cord MRI.The remaining five patients were able to walk independently, complained of leg pain during long distance walking, mild varus or valgus, and no obvious abnormality in spinal cord MRI.Conclusion:In daily activities, except bend down in dancing, falling on the sacral tail is easy to cause spinal cord injury without fracture and dislocation in children. The damaged spinal cord function often cannot recover thoroughly, and even cannot recover. It is advisable to identify early, formulate comprehensive treatment measures in time, strive to improve the prognosis.