胸腰椎骨折稳定性评分的研究  

Scoring in Stability of Thoracic and Lumbar Vertebrae Fracture

作　　者：于宏伟[1] 王文波[1] 王玉学[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院骨科,黑龙江省哈尔滨市150001

出　　处：《中国骨与关节损伤杂志》2008年第4期274-276,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的通过对胸腰椎骨折的X线片、CT、MRI表现的研究,得出判断骨折稳定性的评分标准,指导临床治疗。方法基于三柱理论结合胸腰椎骨折分类方法,对60例胸腰椎骨折的X线、CT、MRI片分别进行评价记分,然后分别以改良的Denis脊柱骨折稳定性判断标准结合AO骨折分类方法和McAfee胸腰椎骨折分类法及其稳定性划分为标准进行检验,并应用SPSS13.0软件进行统计学分析,绘制ROC(receiver operating characteristic)曲线,以评估评分方法的临床价值。结果通过绘制ROC曲线并计算ROC曲线下面积,得出两种检验方法的结果分别是:面积(AO)=0.938、面积(McAfee)=0.927,均>0.9。表明利用本评分方法评判胸腰椎骨折稳定程度的敏感性较高。结论本评分方法具有较高准确性,可以为胸腰椎骨折治疗的选择提供可靠依据,是一种判断胸腰椎骨折稳定性切实可行的方法。Objective To establish a scoring system for the diagnosis of the stability of these fractures and the guidance at the treatment choice in the clinical background through the research in the roentgenograph, CT scanning and MRI of the patients who suffer from fractures in the lumbar and thoracic vertebrae. Methods Based on the Denis three column theory, combined with the routine classifications on thoracolumbar vertebrae fracture, the roentgenograms, CT and MRI of 60 patients with vertebral fractures in the thoracolumbar rejoin were observed. Each injured part （e. g. bone fragment, torn ligament） was differently scored according to its effect contributed to the instability of the spine, and the total score was acquired subsequently. This criteria was then testified for its specificity by the AO and McAfee classification systems, using SPSS 13.0 for the statistical analysis, through drawing ROC （receiver operating characteristic） curve to determine the exactness of this scoring method. Results The area under the ROC curve was calculated. The area in terms of AO classification was 0. 938, and the area in terms of McAfee classification was 0. 927, both of which were more than 0.9. The result indicated that this scoring method on the stability of thoracic and lumbar vertebrae fractures had high specificity. Conclusion This scoring method has high specificity with the AO and McAfee classification system, and could provide credible information for the clinical treatment of choice.

关 键 词：胸腰椎 稳定性 ROC曲线 骨折 

分 类 号：R683.2[医药卫生—骨科学] R683.42[医药卫生—外科学]