中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (48): 9025-9029.doi: 10.3969/j.issn.2095-4344.2012.48.018

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

胸腰椎及腰椎爆裂骨折致神经功能损伤的危险因素

彭银虓,权正学,肖 波,彭 磊,钟伟洋   

  1. 重庆医科大学附属第一医院骨科,重庆市 400016
  • 收稿日期:2012-02-07 修回日期:2012-04-10 出版日期:2012-11-25 发布日期:2012-11-25
  • 通讯作者: 权正学,教授,重庆医科大学附属第一医院骨科,重庆市 400016 quanzx18@126.com
  • 作者简介:彭银虓★,男,1986年生,四川省都江堰市人,汉族,重庆医科大学在读硕士,主要从事脊柱外科的研究。 Pengyx31@126.com

Risk factors for nerve function damage caused by thoracolumbar and lumbar burst fractures

Peng Yin-xiao, Quan Zheng-xue, Xiao Bo, Peng Lei, Zhong Wei-yang   

  1. Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Received:2012-02-07 Revised:2012-04-10 Online:2012-11-25 Published:2012-11-25
  • Contact: Quan Zheng-xue, Professor, Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China quanzx18@126.com
  • About author:Peng Yin-xiao★, Studying for master’s degree, Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China pengyx31@126.com

摘要:

背景:目前国内外学者对于胸腰椎及腰椎爆裂骨折所诱发致神经功能损伤的危险因素研究结果存在差异性。
目的:探讨脊柱胸腰段及腰段爆裂骨折后椎管狭窄程度及后方韧带复合体完整性与神经功能损伤程度之间的关系。
方法:回顾性分析2002年4月至2011年10月重庆医科大学附属第一医院骨科收治的156例胸腰椎及腰椎爆裂骨折患者,分别进行脊柱CT横断面椎管正中矢状径测量、后方韧带复合体完整性及神经功能损伤程度评估,并行统计分析。
结果与结论:94例患者有不同程度神经功能损伤,其损伤程度与椎管占位程度显著相关,其中T12椎管占位程度与神经功能损伤程度相关性最高(rs =0.87、P < 0.001),T11节段椎管占位程度与神经功能损伤程度相关性最低(rs=0.59、P < 0.001);后方韧带复合体损伤与神经功能损伤程度显著相关(OR=3.82,P < 0.001)。提示脊柱胸腰段骨折椎管狭窄程度、后方韧带复合体完整性与患者神经功能损伤程度有显著相关性。

关键词: 爆裂骨折, 椎管狭窄程度, 后方韧带复合体, 神经功能损伤, 胸椎, 腰椎, 危险因素, 后方韧带复合体

Abstract:

BACKGROUND: Nowadays, there are different opinions on risk factors of nerve damage caused by thoracolumbar and lumbar burst fractures.
OBJECTIVE: To analyze the relationship between the posterior ligamentous complex integrity, degrees of spinal stenosis and neural function damage after thoracolumbar and lumbar burst fractures.
METHODS: A total of 156 patients with thoracolumbar and lumbar burst fractures were included in this retrospective analysis, the patients were collected from the Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University (2002-04/2011-10). The spinal canal sagittal diameter of spine CT cross-sectional was measured, the integrity of posterior ligamentous complex and neural function damage was evaluated, and the statistical analysis was performed.
RESULTS AND CONCLUSION: Neural function damage was found in 94 patients. There was a significant correlation between neural function damage and degrees of spinal stenosis. At the T12 level, neural function damage showed the highest correlation with degrees of spinal stenosis (rs=0.87, P < 0.001). At the T11 level, neural function damage showed the lowest correlation with degrees of spinal stenosis (rs =0.59, P < 0.001). The posterior ligamentous complex integrity was significantly correlated with neural function damage (odd ratio=3.82, P < 0.001). The posterior ligamentous complex integrity and degrees of spinal stenosis were significantly correlated with neural function damage in patients with thoracolumbar fractures.

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