| Objective:Investigate the factors, pathogenesis, diagnosis and therapy of hyponatremia after acute cervical spinal cord injury(ACSCI).Methods:290 patients with ACSCI were retrospectively analyzed. The patients were classified by ASIA Impairment Scale, then the number and incidence of the hyponatremia in every grade were counted. The location of injury was definited by imaging that included X-ray, CT and MRI. Theχ2 test(α=0.05) was used to analysis the data of the rate of the hyponatremia in people who had cervical fracture or dislocation and not. Calculate the incidence of hyponatremia in the cervical vertebras where anatomic locations or structures were damaged.Results:56 patients were suffered from hyponatremia, and the rate was 19.31%; patients with serum sodium 130～134 mmol/L were 76.79%, patients with serum sodium 120～129 mmol/L were 16.07% ;and patients with serum sodium lower than 120 mmol/L were 7.14%. The date of hyponatremia occurred ranged from 1 to 40 days after injury, and the average was 5.93 days. The minimum duration of hyponatremia was 1 day,but the maximum was longer than 38 days, so a median was 12 days. 290 patients were categoried by ASIA Impairment Scale; there were 76 patients in A,and 30 patients were suffered from hyponatremia,the incidence was 39.47%;there were 29 patients in B,and 4 patients were suffered from hyponatremia,the incidence was 13.79%; there were 31 patients in C,and 7 patients were suffered from hyponatremia,the incidence was 22.58%; there were 101 patients in D,and 12 patients were suffered from hyponatremia,the incidence was 11.88%; there were 53 patients in A,and 3 patients were suffered from hyponatremia,the incidence was 5.66%. 290 patients were definited by imaging. 108 patients who had no fracture or dislocation were combined with cervical disc herniation or cervicalcanal stenosis. And the rest of them got damages to anatomic locations or structures. 25 patients had no fracture or dislocation, 31 patients had fracture or dislocation, and both of them were diagnosed as hyponatremia. The data of the 56 patients was analysised byχ2 test, the result was P﹥0.05. 182 patients who had fracture or dislocation in cervical were categorized by the location of injury. The patients who were not hyponatremia were injured in C1, C3, C1～2, C3～4, C2 with C6, C3～5, C5～7 and C4～7. The incidence of hyponatremia in C2 was 7.14, C4 was 7.41%, C5 was 18.42%, C6 was 33.33%, C7 was 30.00%, C4～5 was 37.50%, C5～6 was 40.00%, C6～7 was 16.67%, C4～6 was 100.00%.Conclusion:The hyponatremia was related with the injury ,and had nothing to do with the location and type of injury. But the mechanism of the hyponatremia secondary to ACSCI was not clear. The spine cord wasting salt syndrome gave us a new interpretation to hyponatremia after ACSCI. We should monitor and pay attention to patients'status, serum sodium, blood pressure, and 24 h urinary volume, creatinine, and sodium. then we chose the appropriate treatment in accordance with the index which we monitored.
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