多节段脊柱骨折诊疗方法的分析

Diagnosis and treatment of multiple-segment spinal fractures

目的分析多节段脊柱骨折的诊疗方法、伤情特点.方法回顾性分析1996年4月～2005年1月54例脊柱多节段骨折患者,探讨致伤原因、损伤节段分布及治疗效果.结果患者平均年龄43.2岁,50岁以下占59.3%.Ⅰ型骨折33例,Ⅱ型骨折21例,其中胸、腰段及腰椎多节段骨折33例,占61.1%,合并神经损伤37例,占68.5%.致伤原因为高处坠落伤、交通事故伤和重物砸伤占83.3%.手术治疗27例,非手术治疗27例.30例患者获得随访,平均随访14.6个月,随访病例中22例伤时有神经损伤,其中90.9%的病例治疗后神经功能恢复1～2级.结论多节段脊柱骨折患者以男性中青年多见,多数伴有神经损伤.最常见的致伤原因是高处坠落伤、交通事故伤和重物压砸伤.全面、仔细地检查伤情,早期正确诊断与治疗,可获得良好效果.

Objective To study the injury characteristics, diagnosis and treatment of multiple-segment spinal fractures （MSF）. Methods Fifty-four cases with MSF from April 1996 to January 2005 were retrospectively analysed to explore the cause of injury, the distribution of injured segments and effect of treatment. Results The patients＇ mean age was 43.2 years and 59.3% of them were under 50 years old. Of the 54 cases, there were 33 cases of type Ⅰ fracture and 21 cases of type Ⅱ. Multiple-segment thoracolumhar and lumbar fractures occurred in 33 cases（61.1%） , and compound neurological injuries occuffed in 37 eases（68.5%）. The patients associated with high fall , traffic accident and heavy pound injury in the group were 83.3%, Twenty-seven cases were surgically treated and 27 cases were conservatively treated. Thirty cases were followed up for an average period of 14.6 months. Among them there were 22 cases with neurological injuries and the function of spinal cord in 90.9% of the cases was improved 1 or 2 grades. Conclusion MSF are very common in young and middle-aged male mostly associated with neurological injuries. The most common causes of MSF are high fall, traffic accident and heavy pound. Through overall and carefully examination, early correct diagnosis and treatment can acquire a good effect.