胸腰椎屈曲牵张型损伤的研究进展  

Research progress in thoracolumbar flexion-distraction injury

作　　者：张国权 黄亮亮 周旭 李方 ZHANG Guo-quan;HUANG Liang-liang;ZHOU Xu;LI Fang(Postgraduate School,Hubei University of Medical,Shiyan 442000,Hubei,China;Orthopaedic Department,General Hospital,PLA Central Theater Command,Wuhan 430070,Hubei,China;The First School of Clinical Medicine,Southern Medical University,Guang-zhou 510515,Guangdong,China)

机构地区：[1]湖北医药学院研究生院,湖北十堰442000 [2]中部战区总医院骨科,湖北武汉430070 [3]南方医科大学第一临床医学院,广东广州510515

出　　处：《中国矫形外科杂志》2025年第5期436-441,共6页Orthopedic Journal of China

基　　金：国家自然科学基金青年项目(编号:81902213);湖北省卫生健康委青年人才项目(编号:WJ2021Q054)。

摘　　要：屈曲牵张型损伤(flexion distraction injury,FDI)为脊柱三柱损伤,好发于胸腰椎,特点为棘突或后方韧带复合体(posterior ligamentous complex,PLC)损伤,可伴有椎体压缩骨折或爆裂骨折,Chance骨折仅为FDI的一个亚型。在临床中,可能更关注显而易见的椎体骨折及神经压迫,而对胸腰椎屈曲牵张型损伤(thoracolumbar flexion distraction injury,TLFDI)认识不足,容易漏诊误诊,阻碍了临床治疗方案的选择。不当的治疗方案会导致脊柱不稳以及神经功能恶化等。本文旨在对目前TLFDI的损伤机制、临床分型、诊断方法、治疗方案选择及是否去除内固定的相关研究进展进行综述,以期加强临床医生对此类损伤的认识,为TLFDI临床治疗提供参考。The flexion-distraction injury(FDI)is a three-column spinal injury commonly occurring in the thoracolumbar region,charac⁃terized by damage to the spinous process or the posterior ligamentous complex(PLC).It is often accompanied by vertebral compression frac⁃tures or burst fractures,while Chance fractures represent only one subtype of FDI.In clinical setting,the attention is often given to the more apparent vertebral fractures and neural compression,while understanding to thoracolumbar flexion-distraction injuries(TLFDI)remains in⁃adequate,which usually leads to misdiagnosis and missed diagnosis,and hampers appropriate selection of treatment plans.Inproper treat⁃ment strategies can result in spinal instability and worsening of neurological function.This article aims to review the current progress in the injury mechanism,clinical classification,diagnostic methods,treatment options,and the debate on whether to remove internal fixation for TLFDI,to enhance clinicians'understanding of these injuries and provide a reference for clinical decision-making in TLFDI management.

关 键 词：屈曲牵张型损伤 胸腰椎骨折 研究进展 综述 

分 类 号：R681.5[医药卫生—骨科学]