用AF系统治疗胸腰椎爆裂型骨折的X线及CT评价  

CT and X-ray evaluation of the AF-fixation system in the treatment of burst fracture of the thoraco-lumbar spine

作　　者：金舜瑢[1] 元虎[1] 李林[1] 玄东泽[1] 李康杰[1] 崔白日[1] 李成福[1] 

机构地区：[1]延边大学医学院附属医院,吉林延吉133000

出　　处：《中国骨伤》2002年第8期462-464,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的　用X线及CT影像 ,从形态学角度分析AF系统治疗胸腰椎爆裂型骨折的临床意义。方法　用脊柱后路AF系统 ,在不处理脊柱后柱的情况下单纯行复位内固定术治疗胸腰椎不稳定性爆裂型骨折 32例 ,手术之后在X线平片及CT扫描影像上 ,测量受损脊柱的中柱和椎管正中前后径 ,来评价其相互关系和改善率。结果　受损椎体中柱高度从术前的平均 6 6 1%恢复到 95 5 % ,改善率平均为 2 9 4 % ,受损椎管前后径从术前的平均 5 8 5 %恢复到 88 5 % ,改善率为 30 0 %。椎体中柱高度的改善率越高椎管前后径长度的改善率就越高。随访 2个月～ 5年 ,术前有神经功能损伤的 8例 ,全部恢复正常。结论　根据X线及CT影像学分析 ,椎管前后径的改善率与椎体中柱高度的改善率成正相关 ,为爆裂型骨折不应首先考虑前路及后路减压提供了理论根据。对脊柱爆裂型骨折不伴有完全瘫痪的病例AF技术应作为首选。Objective X ray and CT scan were used for morphometric analysis to evaluate the clinical significance of AF fixation technique in the treatment of the burst fracture of the thoraco lumbar spine.Methods 32 patients with unstable burst fracture of the thoraco lumbar spine were treated with the AF fixation operation without posterior column decompression.The middle spinal column and the diameter of vertebral foramen were measured on the primary and post operative X ray and CT scan.The data were analysed and the rates of improvement evaluated.Results The injured spinal middle column improved from 66 1% to 95 5%.The rates of improvement reached an average of 29 4%.The injured foramen vertebrae diameter improved from 58 5% to 88 5% with the rates of improvement of 30 0%.Foramen vertebrae diameter improved as much as the happened in the middle column;the followed up lasted from 2 months to 5 years.8 cases with nerve functional problem had completely recovery.Conclusion According to the X ray and CT evaluation,it was recognized that foramen vertebrae diameter improvements increased as much as that in the middle column;the results provided the theoretical bases for the idea that anterior or posterior decompression should not be considered for the teatment of thoraco lumbar burst fracture.AF fixation system is the first choice for the treatment of burst fracture of the thoraco lumbar spine without the complication of complete paralysis.

关 键 词：CT 椎体骨折 内骨折固定术 图像解释 治疗 

分 类 号：R683.205[医药卫生—骨科学]