胸腰椎椎体压缩性骨折后椎体假关节的5种体位X射线侧位平片特点  

Radiographic evaluation of thoracolumbar and/or lumbar vertebral pseudoarthrosis on five positions

作　　者：崔伟[1] 高桥启介 齐藤文则 

机构地区：[1]广西中医学院瑞康医院,广西壮族自治区南宁市530011 [2]日本琦玉医科大学医院,日本国琦玉县毛吕山町350-0495

出　　处：《中国组织工程研究与临床康复》2008年第26期5063-5066,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景：许多临床研究阐述了胸腰椎椎体压缩性骨折后应用常规侧位片来评定是否有假关节形成,作者所查应用仰卧或（和）俯卧侧位X射线片来诊断椎体真空征的文献较少。目的：观察胸腰椎椎体压缩性骨折后椎体假关节的5种体位X射线侧位平片的特点。设计、时间及地点：回顾性病例分析,2002-03/2006-04日本琦玉医科大学医院骨科住院患者。对象：共收治胸、腰椎压缩性骨折患者31例,其中出现椎体假关节患者11例,男2例,女9例;年龄65-83岁,平均74.5岁;累及病变椎体：T113例;T127例;L31例。方法：所有患者均观察测量其站立位（中立位、过屈位、过伸位）、仰卧位、俯卧位5种位置的侧位X射线平片,均由1名脊柱外科副教授每隔2周连续测量3次。主要观察指标：①病变椎体前高度。②病变椎体后突角。③椎体真空征的计数。结果：①俯卧位、仰卧位X射线平片上椎体前高度和病变椎体后突角与直立侧位、过屈位、过伸位比较,差异有显著性意义（P〈0.05）,直立侧位、过屈位、过伸位3组之间差异无显著性意义（P〉0.05）。②在直立侧位及过屈侧位X射线平片上,11例患者均未出现椎体真空征,过伸侧位上出现4例（36%）,俯卧位及仰卧位均出现椎体真空征（100%）。结论：仰卧、俯卧侧位X射线片能更为精确的显示胸腰椎椎体压缩性骨折后椎体假关节的存在。BACKGROUND： Many clinical studies have demonstrated that pseudoarthrosis formation after thoracolumbar vertebral compression fracture is often assessed using lateral films. However, there are few articles about lateral radiographs at supine or prone position. OBJECTIVE： To observe the characteristics of vertebral pseudoarthrosis after thoracolumbar vertebral compression fracture in five lateral radiographies. DESIGN, TIME AND SETTING： Retrospective case analysis was performed at Department of Orthopedics, Hospital of Saitama University from March 2002 to April 2006. PARTICIPANTS： Thirty-one cases of thoracic or lumbar vertebral compression fracture admitted to this hospital, and vertebral pseudoarthrosis occurred in 11 cases including 2 males and 9 females with an average of 74.5 years （range 65-83 years）. The fracture involved T11 in 3 cases, T12 in 7cases and L3 in 1 case. METHODS： All patients underwent five lateral plain radiographies, neutral in sitting, flexion and extension in standing position, supine and prone position. These measurements were performed three times by the same observer every two weeks. MAIN OUTCOME MEASURES： Anterior vertebral body height; vertebral kyphotic angle; intravertebral clefts （vacuum phenomenon） in vertebral bodies. RESULTS： There were significant differences in mean anterior vertebra heights and vertebral kyphotic angle of prone position and supine position compared with sitting lateral position, flexion position, and extension position （P 〈 0.05）. But no significant differences were found among sitting, flexion and extension （P 〉 0.05）. Intravertebral clefts （vacuum phenomenon） were observed in none of 11 cases on sitting and flexion positions, in 4 of 11 （36%） on extension, and 1 lof 11 （100%） on supine and prone positions. CONCLUSION： Supine or prone lateral radiographs can precisely show vertebral pseudoarthrosis following thoracolumbar vertebral compression fracture.

关 键 词：椎体压缩性骨折 假关节 X线 诊断 

分 类 号：R318[医药卫生—生物医学工程]