颈椎棘突骨折与颈椎稳定性  

Cervical Spinous Process Fracture and Cervical Spinal Stability

作　　者：秦德安[1] 张佐伦[2] 崔新刚[2] 刘峰[2] 

机构地区：[1]山西省人民医院骨科,太原市030012 [2]山东省立医院脊柱外科

出　　处：《中国骨与关节损伤杂志》2006年第9期687-689,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨不同类型颈椎棘突骨折与颈椎稳定性的关系。方法回顾性研究14例(15个)单纯颈椎棘突骨折,分为无椎板累及和椎板累及两组,分析受伤机制、病理特点、影像表现和治疗方法;使用AdobePhotoshop软件测量两组侧位X线片骨折线与水平线夹角,SPSS11·0作均数t检验。结果无椎板累及者9例,椎板累及者5例,两组骨折线与水平线夹角分别为57·32°±7·27°和24·36°±6·91°,t=8·260(P<0·05),差异有统计学意义。5例均证实有颈椎不稳,4例行前路手术。结论累及棘突椎板线的颈椎棘突骨折存在颈椎不稳,治疗方法不同于常见的铲土者骨折,需常规摄颈椎过伸过屈侧位X线片,以便早期作出诊断与正确的处理。Objective To discuss the relationship between two different types of cervical spinous process fracture and cervical spinal stability. Methods Retrospectively, fourteen patients with isolated cervical spinous process fractures were divided into two groups： one was nonspinolaminar breach and the other was spinolaminar breach. All were reviewed about their injury mechanisms, pathologic and photographic characteristics and treatment methods. Angles between the fracture line and the horizontal line were measured by Adobe Photoshop software and contrasted by SPSS 11.0 with Student t test. Results Nine patients were nonspinolaminar breach and the rest five were spinolaminar breach. The angles were 57.32±7.27 （ n = 9） and 24.36±6.91 （ n = 5） respectively and t value was 8. 260 （P 〈 0.05）. There was statistically difference between two groups. The cervical spinal instability was confirmed in all five patients, Four cases were operated through anterior approach. Conclusion Spinous process fractures with spinolaminar breach have cervical spinal instability and the treatment strategy is different from that of common clay - shovelers fracture. The cervical hyperflexion and hyperextension lateral plains are supposed routinely so as to diagnose early and treat correctly.

关 键 词：颈椎 棘突骨折 稳定性 棘突椎板线 

分 类 号：R683.2[医药卫生—骨科学]