胸腰椎爆裂性骨折椎管狭窄程度、后凸畸形与神经损伤及预后的关系  

The correlation about the degree of spinal canal stenosis and kyphosis deformity with the recovery rate and prognosis of thoracolumbar burst fracture in nerve injury

作　　者：焦根龙[1] 赵明杰[1] 潘永勤[1] 蔡树鹏[1] 林永新[1] 

机构地区：[1]暨南大学附属第一医院骨科,广东广州510630

出　　处：《暨南大学学报（自然科学与医学版）》2009年第4期449-451,共3页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：广州市科技计划项目(2006Z3-E5191)

摘　　要：目的:通过观察爆裂性胸腰椎胸腰段骨折并神经损伤的临床资料,评价椎管狭窄程度、后凸畸形对神经损伤的影响及恢复的临床意义.方法:收集144例爆裂性胸腰椎骨折的病例,经过随访半年到6年(平均2.6年),回顾性评价ASIA评分、椎管狭窄率、后突角与神经损伤、功能恢复之间的关系.结果:144例病例中有47例有神经损伤及其伤后ASIA评分平均为32(0-50分),随诊结束时平均为44.2(24～50分),除2例死亡外,总恢复率达68.6%.A组(无神经损伤)、B组(不全瘫)、C组(全瘫)3组之间的椎管狭窄率、后突角无显著差异性(P>0.05);椎管狭窄率、后突角与伤后ASIA评分、最后ASIA评分和恢复率三者之间无显著的相关性(P>0.05).结论:椎管狭窄率和后突角不能完全作为评价爆裂性胸腰椎骨折后神经损伤及恢复程度的依据.Aim: To evaluate the clinical significance of the degree of spinal canal stenosis and kyphosis deformity in nerve injury and its recovery through the Observation curative effect of thoracolumbar burst fractures.Methods: One hundred and forty-four cases of thoracolumbar burst fractures were collected to follow up half a year to 6 years(average 2.6 years),the correlation of the ASIA score,the stenotic ratio of spinal canal and kyphotic angle to nerve injury and its function recovery was evaluated through a retrospective analyse.Results: Among the 144 cases,47 cases had nerve injury,ASIA score was 32 on average(range,0~50) at post-injury,44.2(range,24~50) on average at the end of follow-up.The total recovery rate reached 68.6% except 2 cases died.There was no statistic difference(P>0.05)with respect to the stenotic ratio of spinal canal and kyphotic angle among Group A(no nerve injury),Group B(incomplete paralysis) and Group C(complete paralysis).The stenotic ratio of spinal canal,kyphotic angle are not significantly related to post-injury-ASIA-score,final ASIA score and recovery rate.Conclusion:The stenotic ratio of spinal canal and kyphotic angle can not be absolutely used to determine the degree of nerve injury and the recovery rate of thoracolumbar burst fractures.

关 键 词：爆裂性胸腰椎骨折 神经损伤 椎管狭窄程度 后凸畸形 恢复率 

分 类 号：R697[医药卫生—泌尿科学]