摘要
目的探讨X线正位片中椎弓根间距(IPD)在预判胸腰椎爆裂骨折严重程度的价值。方法回顾性分析自2010-03—2012-12已确诊为胸腰椎爆裂骨折(单一椎体)的43例,测量胸腰椎X线正位片中骨折椎体及其上下2个椎体的IPD,根据多平面重建CT及MRI进行负荷分担评分及TLICS评分,同时进行ASIA分类,分析IPD与负荷分担评分、TLICS评分及ASIA分类之间的关系。结果 IPD增宽38例(88.4%),可疑增宽2例(4.7%),没有增宽3例(7.0%)。IPD与ASIA分类(r=0.33,P=0.035<0.05)、TLICS评分具有显著相关性(r=-0.37,P=0.017<0.05)。IPD与负荷分担评分之间没有相关性(r=-0.116,P=0.469>0.05)。结论对于急性创伤所致的胸腰椎爆裂骨折,X线片中IPD有助于预判胸腰椎爆裂骨折严重程度,可为临床医师制定下一步检查及治疗方案提供指导。
Objective To investigate the value of interpedicular distance on anteroposterior plain radiographs to predict the severity of thoracolumbar burst fractures. Methods Forty three patients diagnosed with thoracolumbar burst fractures treated in our spinal surgery department from Mar. 2010 to Dec. 2012 were retrospectively analyzed. All of patients had single-level vertebral burst fracture, and the IDP(interpedicular distance) on X-ray of fractured vertebra was measured, compared with above and below IDP of fractured vertebra. The load sharing score, the thoracolumbar injury classification and severity score(TLICS) and ASIA neurological classification of spinal cord injury were recorded according to the findings of CT, MRI and the symptom and physical sign of patients. The relationship between IDP and these three scoring system was analyzed. Results On plain radiographs of the spine in the AP, the IDP was widened in 38 patient(88.4%) and there was no change in 3 patients(6.9%). The IDP of 2 patients(4.7%) was suspected with broadening. The IDP was significantly correlated with ASIA neurological classification of spinal cord injury(r =0.33,P =0.035 <0.05), as well as TLICS(r =-0.37,P =0.017 <0.05.However, there was no relationship between IDP and the load sharing score(r =-0.116,P =0.469>0.05). Conclusion IPD measured from plain radiographs is useful to assess the severity of thoracolumbar burst fractures in acute spinal injury patients, which provides important information to help physician make further decision.
出处
《中国骨与关节损伤杂志》
2014年第5期430-432,共3页
Chinese Journal of Bone and Joint Injury
关键词
X线片
CT
MRI
椎弓根间距
脊柱爆裂骨折
胸腰椎
X-ray plain
CT
MRI
Interpedicular distance
Spinal burst fracture
Thoracolumbar vertebra
