摘要
目的对AO分型中B型胸腰段骨折椎体邻近椎间盘在MRI的特点进行总结。方法回顾性分析2008年1月至2011年1月65例B型胸腰段骨折患者的MRI资料,观察骨折椎体上位及下位椎间盘的形态学特征及信号变化,总结其影像学特点。结果 65例患者中,共累及69个椎体,134个椎间盘。其分型为:1型:椎间盘形态正常或接近正常,无明显信号异常及椎间隙改变,占31.3%;2型:椎间盘上下终板损伤,髓核少部分疝入椎体,椎间盘信号正常或接近正常,伴或不伴椎间隙改变,占6.7%;3型:椎间盘前1/3部形态及信号异常,椎间隙增宽,伴或不伴椎间盘向前疝出,占27.6%;4型:椎间盘后1/3部形态及信号异常,椎间隙变窄,伴或不伴椎间盘向后疝出,占28.4%;5型:椎间盘形态及信号异常,正常椎间盘形态消失,椎间隙变窄,伴或不伴髓核向前或向后疝出,占6.0%。结论 AO分型中B型胸腰段骨折椎体常伴有邻近椎间盘损伤,不同分型的骨折导致的椎间盘损伤类型也不同,了解其规律对临床手术具有指导意义。椎间盘分型属于1型的B型胸腰段骨折患者,可行后路撑开复位内固定术,不做椎间融合;椎间盘分型属于2～5型的B型胸腰段骨折患者,需行损伤椎间盘切除,椎间植骨融合内固定术。
Objective To summarize the features on MR imaging of the adjacent intervertebral discs in type B thoracolumbar fractures（ AO classification） and analyze clinical significance. Methods Collecting 65 patients＇MR imaging data in type B thoracolumbar fractures between January 2008 and January 2011, observing the morphology and signal changes of upper and lower intervertebral discs, summarize the features and analyze clinical significance. Results In 65 patients,involving 69 vertebrae, 134 discs, it can be sorted to 5 types ：Typel ：The disc was normal or near normal morphologically without obvious signal and intervertebral changes （31.3%）. Type2 ： Endplates damages accompanied with a small part of nucleus pulposus herniation. The signal of disc was normal or near normal could combine with intervertebral changes（6.7% ）. Type3 ：There were morphology and signal changes in anterior 1/3 of the disc with intervertebral space increased, and the herniation forward of the disc could be observed （27.6%）. Type4： There were morphology and signal changes in posterior 1/3 of the disc with intervertebral space decreased, and the herniation backward of the disc could be observed. Type5 ：The morphology and signal changes occurred in the disc. The normal disc structures was not exist any more. Intervertebral space decreased and herniation forward or backward of the disc could be seen（6% ）. Conclusions We recommend that the patient whose disc belongs to typel of type B thoracolumbar fractures should accept reduction and internal fixation of posterior distraction, interbody fusion is not advised. The disc type belongs to 2-5, should accept damage tissue resection,interbody fusion and internal Fixation.
出处
《中华临床医师杂志（电子版）》
CAS
2012年第7期I0014-I0017,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
脊柱骨折
椎间盘
磁共振成像
Spinal fractures
Intervertebral disk
Magnetic resonance imaging
