摘要
目的:探讨胸腰段爆裂骨折椎管内骨块占位程度与早期神经损伤的关系。方法:对2000年1月至2009年12月收治的115例胸腰段爆裂骨折急性期患者的CT扫描图像与神经损伤情况进行回顾性分析。无神经损伤组(A组)43例,神经损伤组(B组)72例。对患者CT图像运用ImageJ图像分析软件进行测量,分别对伤椎及其相邻上下椎的椎管横径、矢状径和面积进行测量,计算相应的椎管占位率和矢状径与横径比值,将无神经损伤组与神经损伤组进行统计学分析。结果:伤椎的椎管矢状径、面积和矢状径/横径比值在T12节段A组分别为14.2±1.7mm、233±47mm2和0.66±0.06,B组为10.1±2.2mm、139±50mm2和0.52±0.10;L1节段A组分别为11.7±3.3mm、203±70mm2和0.56±0.16,B组为9.6±2.9mm、160±56mm2和0.45±0.11。胸腰段爆裂骨折两组伤椎的椎管矢状径、面积及矢状径/横径比值在T12和L1节段比较,差异有显著性(P<0.05),两组伤椎椎管横径间比较差异无显著性(P>0.05)。L2节段两组观察指标差异无显著性。结论:爆裂骨折椎管狭窄程度与神经损伤在T12和L1节段相关,测量椎管矢状径、椎管面积、矢状径与横径比值可以作为神经损伤程度的预测因素,而椎管横径改变与神经损伤不相关。
Objective：To explore the relationship between acute neurological deficit and spinal canal compromise in patients with thoracolumbar burst fractures.Method：A total of 115 patients with acute thoracolumbar burst fracture from January 2000 to December 2009,including 72 neurologic deficit and 43 neurologic intact, were reviewed retrospectively.Computed tomographic scans were used to measure the sagittal diameter （SD）, transverse diameter（TD） and the cross-sectional area（CSA） of the spinal canal at the level of injury,as well as one level proximal and distal to the fracture level.The ratio of sagittal-to-transverse diameter （S/T ratio） and the percentage of spinal canal compromise were calculated.Statistical analysis was used to compare those with neurologic deficit to those without.Result：The mean SD,CSA and S/T ratio in group A at T12 was 14.2mm,233mm2,0.66 respectively,while those in group B was 10.1mm,139mm2,0.52 respectively.The mean SD,CSA and S/T ratio in group A at L1 was 11.7mm,203mm2,0.56 repectively,and those in group B was 9.6mm,160mm2,0.45 respectively.SD,S/T ratio and CSA at T12 and L1 levels in patients with a neurologic deficit were significantly smaller than those without a neurologic deficit（P0.05）.The mean transverse diameter at the level of injury showed no significance in two groups （P0.05）.The mean SD,CSA and S/T ratio in group A at L2 showed no significance in two groups （P0.05）.Conclusion：Neurological deficit correlate with SD,S/T ratio and CSA in T12 and L1 burst fracture,which can be used as predictive of neurologic deficit, while the transverse diameter of canal shows no correlation with neurological deficit.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2010年第10期839-843,共5页
Chinese Journal of Spine and Spinal Cord
关键词
胸腰段
爆裂骨折
脊髓损伤
椎管占位
CT
Thoracolumbar spine Burst fracture Spinal cord injury Canal compromise CT scan
