超声检查胸腰段后方韧带复合体损伤的可行性研究  

Feasibility study of ultrasonic examination of thoracolumbar posterior ligament complex injury

作　　者：李东洋 刘瑞[2] 姜助国 Li Dongyang;Liu Rui;Jiang Zhuguo(Inner Mongolia Medical University,Hohhot Inner Mongolia,010050;Department of Orthopedics,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot Inner Mongolia,010030,China)

机构地区：[1]内蒙古医科大学,内蒙古呼和浩特010050 [2]内蒙古医科大学附属医院骨科,内蒙古呼和浩特010030

出　　处：《生物骨科材料与临床研究》2024年第6期63-68,共6页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的研究超声检查胸腰段后方韧带复合体(posterior ligament complex,PLC)损伤及损伤程度的准确性与特异性,明确在某些特殊情况下,使用超声评估后方韧带复合体损伤是否可行。方法收集2021年10月至2024年5月因外伤致胸腰段脊柱骨折并就诊于内蒙古医科大学附属医院骨科的胸腰段脊柱骨折患者共87例。对所有患者进行伤椎区域的超声、MRI检查。评估后方韧带复合体中棘上韧带与棘间韧带的损伤情况并详细记录。以MRI检查结果为标准,分析超声检查评估PLC各部分损伤的灵敏性、特异性和准确性。结果超声检出后方韧带复合体损伤病例阳性48例,阴性39例;MRI检出后方韧带复合体损伤阳性病例53例,阴性34例。超声检查评估棘上韧带、棘间韧带损伤的灵敏性为0.89,特异性为0.97、准确性为0.92。结论在评估后方韧带复合体损伤时,超声的检查结果具有较高的诊断价值,另外超声兼具便携、安全、实时等优点,在患者患有幽闭恐惧症、装有心脏起搏器等MRI无法使用的特殊情况下,可以作为评估后方韧带复合体损伤情况的方法。Objective To study the accuracy and specificity of ultrasonography in detecting the injury and the degree of injury to the posterior thoracolumbar ligament complex.To determine whether ultrasound can be used to evaluate the injury of posterior ligament complex in some special cases.Methods A total of 87 patients with thoracolumbar spinal fracture caused by trauma from October 2021 to May 2024 were collected and treated in the department of orthopedics,the Affiliated Hospital of Inner Mongolia Medical University.Inclusion criteria:Thoracolumbar spine fracture,single segment fracture,definite trauma history;exclusion criteria:fracture more than 5 days,pathological fracture,fracture combined with dislocation.All patients underwent ultrasound and MRI of the injured vertebrae.Injury to the posterior ligamentous complex was assessed and recorded.According to the results of MRI,the sensitivity,specificity and concordance rate of ultrasound in assessing injury to different parts of the PLC were analysed.Results Ultrasound detected posterior ligament complex injury in 48 cases and negative in 39 cases,MRI detected posterior ligament complex injury in 53 cases and negative in 34 cases.The sensitivity,specificity and accuracy rate of ultrasound in the evaluation of supraspinous and interspinous ligament injuries were 0.89,0.97 and 0.92,respectively.Conclusion In the evaluation of posterior ligament complex injury,the results of ultrasound have high diagnostic value,and ultrasound has the advantages of portability,safety and real-time.In special cases such as patients with claustrophobia and equipped with pacemakers,it can be used as a method to evaluate the injury of posterior ligament complex injury.

关 键 词：超声 后方韧带复合体 MRI 胸腰段脊柱骨折 

分 类 号：R683.2[医药卫生—骨科学]