AO胸腰椎损伤分类系统和胸腰椎骨折损伤分类和严重程度评分系统在指导胸腰椎骨折手术中的差异  

Thoracolumbar AO spine injury score versus thoracolumbar injury classification and severity score system in guiding thoracolumbar fracture surgery

作　　者：安忠诚 朱宇尘 王国强 魏浩 董黎强 An Zhongcheng;Zhu Yuchen;Wang Guoqiang;Wei Hao;Dong Liqiang(Department of Spinal Surgery,The Second Affiliated Hospital to Zhejiang Chinese Medical University,Hangzhou 310005,China)

机构地区：[1]浙江中医药大学附属第二医院脊柱外科,杭州310005

出　　处：《中华创伤骨科杂志》2020年第7期598-603,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的:探讨AO胸腰椎损伤分类系统(TL AOSIS)和胸腰椎骨折损伤分类和严重程度评分系统(TLICS)在指导胸腰椎骨折手术中的差异。方法:回顾性研究2015年1月至2016年12月浙江中医药大学附属第二医院脊柱外科收治的55例具有完整术前影像学资料的胸腰椎损伤患者资料。男34例,女21例:年龄21~55岁,平均37.5岁;根据患者的神经功能损伤情况分为无神经功能损伤者(31例)和神经功能损伤者(24例)。用TL AOSIS和TLICS分别对所有患者和有、无神经损伤患者进行评分并给出是否手术的建议。结果:55例患者分别使用TL AOSIS、TLICS指导治疗:保守治疗分别为19、25例,可保守可手术治疗分别为12、13例,手术治疗分别为24、17例;两种评分对于胸腰椎骨折的手术建议具有一致性(P=0.358)。31例无神经损伤患者分别使用TL AOSIS、TLICS指导治疗:保守治疗分别为19、25例,可保守可手术治疗分别为6、0例,手术治疗分别为6、6例;TLICS建议更多的患者选择保守治疗,差异有统计学意义(P=0.033)。24例神经功能损伤患者分别使用TL AOSIS、TLICS指导治疗:可保守可手术治疗分别为6、13例,手术治疗分别为18、11例;TL AOSIS建议更多患者选择手术治疗,差异有统计学意义(P=0.039)。结论:TL AOSIS、TLICS对于胸腰椎骨折的手术建议具有一致性;但对于完全爆裂性骨折或合并神经功能损伤的胸腰椎骨折患者,TL AOSIS比TLICS建议更多的患者选择手术治疗。Objective To compare the differences between thoracolumbar AO spine injury score(TL AOSIS)and thoracolumbar injury classification and severity score system(TLICS)in guiding thoracolumbar fracture surgery.Methods A retrospective study was conducted of the 55 patients with complete preoperative imaging data who had been treated for thoracolumbar injuries at Department of Spinal Surgery,The Second Affiliated Hospital to Zhejiang Chinese Medical University from January 2015 to December 2016.They were 34 men and 21 women,aged from 21 to 55 years(average,37.5 years).Of them,31 were identified as having normal neurological function and 24 as having impaired neurological function.TL AOSIS and TLICS were used to evaluate respectively all the patients,those with normal neurological function and those with impaired neurological function,and consequently made suggestions whether surgery should be performed or not.Results Among the 55 patients,by the guidance of TL AOSIS and TLICS respectively,conservative treatment was suggested for 19 and 25 cases,either conservative treatment or surgery for 12 and 13 cases,and surgery for 24 and 17 cases.There was fine consistency between the 2 scoring systems in surgery suggestion for thoracolumbar fracture(P=0.358).Among the 31 patients with normal neurological function,by the guidance of TL AOSIS and TLICS respectively,conservative treatment was suggested for 19 and 25 cases,either conservative treatment or surgery for 6 and 0 cases,and surgery for 6 and 6 cases.TLICS suggested surgery for significantly more patients than TL AOSIS did(P=0.033).Among the 24 patients with impaired neurological function,by the guidance of TL AOSIS and TLICS respectively,either conservative treatment or surgery was suggested for 6 and 13 cases,and surgery for 18 and 11 cases.TL AOSIS suggested surgery for significantly more patients than TLICS did(P=0.039).Conclusion There is fine consistency between TL AOSIS and TLICS in surgery suggestion for thoracolumbar fracture,but TL AOSIS may lead to more surgery su

关 键 词：胸椎 腰椎 骨折 分型 治疗方案 

分 类 号：R687.3[医药卫生—骨科学]