胸腰椎爆裂骨折椎管内骨块占位与神经损伤  

The spinal canal encroachment on thoracolumbar burst fracture and neurologic deficit

作　　者：蔡福金[1] 刘富华[1] 朱建平[1] 潘功茂[2] 

机构地区：[1]解放军第101医院骨科 [2]解放军第101医院放射科,江苏无锡214044

出　　处：《颈腰痛杂志》2002年第4期289-291,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的　观察胸腰椎爆裂骨折部位及椎管内骨块占位与神经损伤的关系。方法　对 14 1例包括胸椎 (T1 - T1 0 )、胸腰段 (T1 1 - L2 )及腰椎 (L3- L5)三个水平爆裂骨折 CT显示的椎管内骨块占位与神经功能关系进行了分析。结果　神经损伤组椎管内骨块占位程度明显高于无神经损伤组 (P <0 .0 5 ) ;在有神经损伤情况下椎管骨块占位严重程度依次为 :胸椎 <胸腰段 <腰椎 (P <0 .0 5 ) ;在 Frankel分类有功能障碍的四个神经功能级之间其椎管骨块占位程度无显著差异 (P>0 .0 5 )。结论　椎体爆裂骨折椎管内骨块占位压迫是神经损伤的重要危险因素 ;神经损伤的出现与骨折椎体节段和椎管内骨块占位程度联合相关 ;但神经损伤的严重程度与就诊时Objective To study the relationship between the percentage of spinal canal encroachment and neurologic deficit Methods The percentage of spinal canal stenosis was measured from computer tomography in 141 patients with burst fracture of the thoracic(T 1-T 10 ), thoracolumber(T 11 -L 2) and lumbar(L 3-L 5) spine and then the relationship between the percentage of spinal canal encroachment and neurologic deficit was investigated Results The results demonstrated that the percentage of spinal canal stenosis was significantly higher in those with neurologic deficit than in those without (P<0 05) The order of the mean percentage of spinal stenosis in those with neurologic deficit was thoracic<thoracolumbar<and lumbar(P<0 05)and the difference of the mean percentage of spinal stenosis among the four groups of patients with neurologic deficit classified according to Frankel were not statistically significant Conclusion The spinal canal encroachment was a significant risk of neurologic involvement The higher the level of injury and the higher the percentage of spinal canal stenosis, the greater the probability of a neurologic deficit The severity of the neurologic deficit could not be predicted from the spinal canal stenosis demonstrated by CT

关 键 词：胸腰椎爆裂骨折 椎管内骨块占位 神经损伤 

分 类 号：R683.2[医药卫生—骨科学]