创伤性胸腰段椎体骨折伴伤椎上、下椎间盘损伤的危险因素分析  

Risk factors of intervertebral disc lesion in traumatic thoracolumbar vertebral fractures

作　　者：刘建民[1] 袁之木[1] 尹海建 孙文建[1] LIU Jian-min;YUAN Zhi-mu;YIN Hai-jian;SUN Wen-jian(Department of Orthopedics,Nanjing Tongren Hospital Affiliated to School of Medicine of Southeast University,Nanjing,Jiangsu 211102,China)

机构地区：[1]东南大学医学院附属南京同仁医院骨科,江苏南京211102

出　　处：《颈腰痛杂志》2021年第3期289-292,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：宁夏回族自治区自然科学基金(编号:NZ16212)。

摘　　要：目的分析创伤性胸腰段椎体骨折患者出现伤椎上、下椎间盘损伤的危险因素,为临床提供进行椎间盘损伤评估的正确时机。方法回顾分析近5年本院收治的创伤性胸腰段椎体骨折患者137例,其中椎间盘损伤91例,椎间盘正常46例,比较两组患者的基本情况、骨折特点等相关指标,并采用多因素Logistic回归分析引起伤椎上、下椎间盘损伤的独立危险因素。结果两组在体质量指数、致伤原因、Denis分型、椎体楔形角、椎体高度比、椎管占位率等方面具有显著差异(P<0.05),Logistic回归分析显示:Denis分型、椎体楔形角、椎体高度比、椎管占位率为椎间盘损伤的独立危险因素(OR=5.47,OR=1.39,OR=2.62,OR=3.36,均为P<0.05)。结论对创伤性胸腰段椎体骨折中伤椎上、下椎间盘损伤的评估,需综合考虑Denis分型、椎管占位率、椎体高度比、椎体楔形角,而Denis II型、椎管占位率较高的患者应高度怀疑伴有椎间盘损伤。Objective To analyze the risk factors of adjacent intervertebral disc lesion in traumatic thoracolumbar vertebral fractures,and supply clinical indication to conduct disc evaluation.Methods A total of 137 patients diagnosed with thoracolumbar vertebral fractures in recent 5 years were divided into lesion group(91 patients)and normal group(46 patients)according to Sander classification.The individual information and fracture features of two groups were compared,and logistic regression analysis was conducted to conclude the independent risk factors of disc lesion.Results BMI,injury causes,Denis classification,vertebral wedge angle,vertebral height ratio,canal occupancy ratio were risk factors of disc lesion(P<0.05).Logistic regression analysis showed that Denis classification,vertebral wedge angle,vertebral height ratio,canal occupancy ratio were independent risk factors of disc lesion(OR=5.47,OR=1.39,OR=2.62,OR=3.36,all P<0.05).Conclusion The evaluation of disc lesion in thoracolumbar vertebral fractures should consider Denis classification,vertebral wedge angle,vertebral height ratio and canal occupancy ratio comprehensively,especially Denis II type fractures or high canal occupancy ratio should be highly suspicious of having disc lesion.

关 键 词：创伤 脊柱骨折 胸腰段 椎间盘损伤 危险因素 

分 类 号：R683.2[医药卫生—骨科学]