成人急性脊柱脊髓损伤救治流程专家共识（2026版）

doi:10.3877/cma.j.issn.2095-9141.2026.03.002

急性脊柱脊髓损伤是创伤患者致残率较高的严重损伤类型之一，常由高处坠落、交通事故、暴力伤害等高能量损伤机制引起，具有起病急、病情重、救治复杂等特点。由于该类损伤涉及脊柱骨折脱位、脊髓受压及神经功能障碍等多种病理改变，救治全过程涵盖早期评估分级、快速转运与影像诊断、及时减压固定、并发症防控及康复管理等重要节点。本共识基于国内外最新指南与文献证据，结合我国成人临床实践，由骨科、神经外科、重症医学、急诊医学及康复医学等多学科专家协作制订，旨在规范我国急性脊柱脊髓损伤的早期识别与分级、影像学评估与手术治疗、围术期管理及康复干预，以提升整体救治水平与功能预后。本共识已在国际实践指南注册与透明化平台（PREPARE）上注册，注册号为PREPARE-2025CN1399。

关键词: 急性脊柱损伤, 急性脊髓损伤, 救治流程, 分级评估, 手术减压, 专家共识, 成年人

Acute spine and spinal cord injury is one of the serious types of injuries with a high disability rate in trauma patients, typically caused by high-energy injury mechanisms such as falls from height, traffic collisions, and violent impacts. It is characterized by rapid onset, severe illness, and complex treatment. Due to the involvement of multifaceted pathological alterations such as spinal fracture-dislocation, spinal cord compression, and neurological dysfunction, the entire treatment process includes important milestones such as early assessment and grading, rapid transport and imaging diagnosis, timely decompression and fixation, prevention and control of complications, and rehabilitation management. This consensus is developed based on the latest international and domestic guidelines and literature evidence, combined with clinical practice in China, through multidisciplinary collaboration among experts in orthopedics, neurosurgery, critical care medicine, emergency medicine, and rehabilitation medicine. It aims to standardize the early identification and grading, imaging evaluation and surgical treatment, perioperative management, and rehabilitation intervention for adult acute spine and spinal cord injury in China, so as to improve the overall rescue level and functional prognosis. This consensus has been registered on the Practice guidelines REgistration for transPAREncy (PREPARE) platform, with the registration number PREPARE-2025CN1399.

Key words: Acute spine injury, Acute spine cord injury, Management pathway, Graded assessment, Surgical decompression, Expert consensus, Adults

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Expert consensus on the management of acute spine and spinal cord injury in adults (2026 edition)

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Expert consensus on the management of acute spine and spinal cord injury in adults (2026 edition)