DR、CT平扫评估胸腰椎爆裂骨折患者椎管内骨折块间接复位效果研究  

Effect of DR and CT Scan in the Evaluating Condition of Indirect Reduction of Intraspinal Bone Fragment in Patients with Thoracolumbar Burst Fractures

作　　者：全志永 孟庆凯 郭艳鸽 QUAN Zhi-yong;MENG Qing-kai;GUO Yan-ge(South Division Subcenter of Beijing Emergency Medical Center,Beijing 100031,China;Department of Orthopaedic 1,Beijing Fengtai Youanmen Hospital,Beijing 100069,China)

机构地区：[1]北京急救中心南区分中心,北京100031 [2]北京丰台右安门医院骨一科,北京100069

出　　处：《中国CT和MRI杂志》2021年第8期166-168,共3页Chinese Journal of CT and MRI

摘　　要：目的探究DR、CT平扫评估胸腰椎爆裂骨折患者椎管内骨折块间接复位的效果。方法回顾性分析本院2017年8月至2019年2月收治的40例胸腰椎爆裂骨折患者的临床资料,观察DR检查和CT平扫的影像特点,术中利用DR透视检查判断椎管内骨块复位是否标准,利用CT平扫评估椎管内骨块的复位值;对术前、术后骨块占椎管中矢径比例进行分析。结果所有患者术后2周内行CT检查,CT结果显示,术前骨块占椎管中矢径的比例为(34.78±12.97);术后骨块占椎管中矢径的比例为(7.84±3.91)(P<0.05);28例术前神经损伤程度为D级的患者,术后全部改善为E级,术前存在骶神经功能、肌功能障碍的患者,也得到了恢复。22例术前神经损伤程度为E级的患者的神经功能均正常。结论DR、CT平扫能有效在术中、术后评估胸腰椎爆裂骨折患者椎管内骨折块间接复位情况,可为是否进行椎板切除减压提供有效依据。Objective To investigate the effect of DR and CT scan in the evaluating condition of indirect reduction of intraspinal bone fragment in patients with thoracolumbar burst fractures.Methods The clinical data of 40 patients with thoracolumbar burst fractures admitted from August 2017 to February 2019 in our hospital were retrospectively analyzed.The imaging features of DR examination and CT plain scan were observed.During the operation,DR fluoroscopy was used to determine whether the reduction of intraspinal bone meets criterion.The CT scan was used to evaluate the reduction value of the intraspinal bone in the spinal canal.The ratio of bone fragment in radius vector of the spinal canal was analyzed before and after surgery.Results All patients underwent CT examination within 2 weeks after operation.CT results showed that the ratio of bone fragment in radius vector of the spinal canal was(34.78±12.97)before surgery and the ratio of bone fragment in radius vector of the spinal canal was(34.78±12.97)after surgery was(7.84±3.91)(P<0.05).28 patients with nerve damage of grade D before surgery all improved to grade E.Patients with sacral nerve function and muscular dysfunction before surgery also recovered.The neurological function of 22 patients with nerve damage before surgery of grade E was normal.Conclusion DR and CT plain scan can effectively evaluating condition of indirect reduction of intraspinal bone fragment in patients with thoracolumbar burst fractures during surgery and after surgery,which can provide an effective basis to decide whether to carry out laminectomy for decompression.

关 键 词：DR检查 CT平扫 胸腰椎爆裂骨折 椎管内骨折块间接复位 

分 类 号：R445.3[医药卫生—影像医学与核医学] R683[医药卫生—诊断学]