交通事故伤与坠落伤所致多节段脊柱骨折的比较

Comparison of Character of Multiple-level Spinal Fracture by Traffic Accident and Falling Injury

目的 探讨交通事故伤与坠落伤所致多节段脊柱骨折的特点,以利临床诊治。方法 回顾性分析182例多节段脊柱骨折的致伤因素与骨折类型、骨折形式、延迟诊断或漏诊、Frankel分级的关系及治疗结果,结果 发现多节段脊柱骨折主要为交通事故伤和高处坠落伤所致(占81.3％),致伤机制复杂,常合并其他损伤,易于漏诊或延迟诊断。其中交通事故伤多以相邻型骨折为主,骨折形式以椎体爆裂或压缩为主(以前、中柱损伤多见),脊髓损伤较重(FrankelA、B级为多),较少发生延迟诊断或漏诊,而高处坠落伤则以非相邻型骨折为主,易导致后柱(椎弓、椎板、小关节)损伤,脊髓损伤相对较轻,很易发生延迟或漏诊。结论 对较重交通事故伤、高处坠落伤尤应仔细了解受伤情况,宁可多照脊柱(尤其两端)X光片,以免漏诊。必要时行全脊柱摄片,治疗应全面考虑,相互兼顾,据不同骨折类型选择合适治疗方法。

Objective To study the characteristics of multiple-level spinal fracture in accidents and in falling injury to improve clinical treatment. Methods Injury factor fracture type ,delayed or missed diagnosis, Frankel's grade and results of treatment of 182 multiple-level spinal fractures were retrospectively analysed. Results Accidents and falling are major cause of multiple-level spinal fracture(81%). Accidents fracture is characterized as follows (1)majority of type (contiguous 57.3%);(2)majority of vertebra burst of compression; (3) severe spinal cord injury; (4)missed or delayed diagnosis was usually encountered. Conclusion It was recommended that total spine radiography beperformed as soon as possible on major injury patients and different treatment methods was selected according to different fracture.