多节段非相邻型脊柱骨折的诊断与手术治疗  

The Diagnosis and Surgical Treatment of Multi - level Noncontiguous Spinal Fractures

作　　者：张绪华[1] 中小青[1] 吴明宇[1] 张克云[1] 

机构地区：[1]怀化医专附属怀化市第三人民医院骨科,湖南怀化418000

出　　处：《怀化医专学报》2008年第2期29-31,共3页

摘　　要：目的探讨多节段非相邻型脊柱骨折（multi—level noncontiguous spinal fractures，MNSF）的受伤机制、诊断与手术治疗方式。方法对我院1997年1月至2008年1月手术治疗并得到随访的36例MNSF患者的临床资料，按ASIA分级、感觉运动评分进行回顾性分析。结果36例MNSF患者共累及椎体78个节段，关键损伤部位骨折分型以爆裂型和压缩型骨折为主。脊髓不完全性损伤病例（B、c级），感觉运动评分明显提高，随访时与术前比较有显著性差异（P〈0．05），术后ASIA分级分别提高1～2级；脊髓完全性损伤病例（A级）ASIA分级无改善。感觉运动评分随访时与术前比较无显著性差异。结论MNSF具有暴力损伤大、致伤机制复杂、脊髓损伤严重、合并损伤多、易于漏诊或延误诊断等特点，治疗上应明确多节段骨折的关键部位及骨折的性质，并根据多节段脊柱骨折的类型选择相应的固定融合节段。Objective To study the mechanism, diagnosis and surgical treatment of multi - level noncontiguous spinal fractures （MNSF） . Methods 36 cases of MNSF were reviewed retrospectively. The Spinal Injury Association （ASIA）, sensory and motor scores were analyzed. Resdls Totally 78 segments were involved in the 36 cases of MNSF, and follow- up results （average 4.5 years） showed that cases with incomplete spinal cord injury （ASIA grade B and C ）, the ASIA grade improved 1 or 2 grades and there is statistical significant difference （ P 〈 0.05 ） among the sen- sory and motor scores compared with pre - operation, cases with complete spinal cord injury, the ASIA grades could not be improved. Conclusion The treatment of MNSF should define the key location and its characteristic. The fused verte- bra should be determined appropriately according to the types

关 键 词：脊柱骨折 多节段 诊断 手术治疗 

分 类 号：R683[医药卫生—骨科学]