无明显移位AO分型C型胸腰椎骨折的诊治要点  

Key points in the clinical diagnosis and treatment of AO type C thoracolumbar fractures without obvious displacement

作　　者：都金鹏 薛士麟 贺宝荣[1] Du Jinpeng;Xue Shilin;He Baorong(Department of Spine Surgery,Affiliated Honghui Hospital,Xi′an Jiaotong University,Xi′an 710054,China;Department of Orthopedics,Peking University Third Hospital,Beijing 100010,China)

机构地区：[1]西安交通大学医学院附属红会医院脊柱外科,西安710054 [2]北京大学第三医院骨科,北京100010

出　　处：《中华创伤杂志》2024年第11期987-991,共5页Chinese Journal of Trauma

摘　　要：AO分型C型胸腰椎骨折是最为严重的脊柱骨折之一,其中无明显移位C型骨折因影像学表现不典型,且很少伴发神经症状,易被误诊误治,最终导致患者治疗失败、瘫痪等严重后果。MRI检查对其正确诊断至关重要,但多数骨科医师重点关注X线和CT检查结果,易将C型骨折误诊为B型骨折。无明显移位C型骨折为三柱损伤,需要手术治疗,核心是要充分重建三柱的稳定性,但目前临床常见只采用单纯后路固定而导致治疗失败的案例。为此,笔者就无明显移位AO分型C型胸腰椎骨折的诊治进行深入探讨,旨在提高广大骨科医师对其认知水平和重视程度。AO type C thoracolumbar fractures are the most serious type of spinal fractures.Among them,the non‑displaced type C fractures are easy to be misdiagnosed and mistreated because of their atypical imaging manifestations and few associated neurological symptoms,which ultimately lead to serious consequences such as treatment failure and paralysis.MRI examination is crucial for a correct diagnosis,but most orthopedic surgeons make a diagnosis largely based on the results of X‑ray and CT examinations,in which type C fractures are easily misdiagnosed as type B.Non‑displaced type C fractures involve three‑column injuries and require surgical treatment,for which the key is to fully reconstruct the stability of the three columns.However,in the current clinical practice,it is common to use simple posterior fixation only,resulting in treatment failure.To this end,the authors conducted an in‑depth discussion on the diagnosis and treatment of non‑displaced AO type C thoracolumbar fractures,aiming to improve orthopedic clinicians′understanding and awareness of their significance.

关 键 词：脊柱骨折 胸椎 腰椎 AO分型 

分 类 号：R687.3[医药卫生—骨科学]