胸腰椎爆裂性骨折的X线平片和CT诊断价值

Value of X-Ray Plain Film and Computed Tomography Scan for Thoracolumbar Vertebra Burst Fracture

目的探讨胸腰椎爆裂性骨折在X线平片和CT片中的诊断价值。方法对50例急性胸腰椎外伤患者的X线平片和CT表现特点进行回顾性分析,其中胸椎13例,腰椎35例,胸腰椎2例;外伤后全部拍摄X线正侧位片及CT平扫,其中7例行CT冠矢状位重建。结果50例急性脊柱外伤中X线平片清楚显示椎体骨折32例34个椎体为爆裂性骨折,CT清楚显示椎体骨折50例54个椎体骨折(48个椎体为爆裂性骨折),附件骨折13例,小关节脱位1例,见到骨折片突向椎管内22例,椎管内高密度血肿3例,脊髓或神经受压22例。结论X线平片对胸腰椎爆裂性骨折的诊断有一定价值,CT在显示脊柱三柱结构、附件骨折、椎管狭窄、椎间盘突出、脊髓及神经根损伤等细节方面优于X线平片。

Objective To evaluate the diagnostic value of X-ray and computed tomography （CT） in the thoracolumbar bursting fracture. Methods The X-ray plain film and CT finding of 50 cases with acute thoraeolumbar injury were reviewed retrospectively,in which there were 13 cases with thoracic vertebra ,34cases with lumbar vertebra and 2 cases with thoracolumbar vertebra. X- ray photography and CT scan were performed in all patients,and the coronal and sagittal reconstruction was performed in 7eases after injury.. Results In 50 cases,X-ray plain film revealed 32 cases with 34 burst fracture,whereas CT revealed 50 cases involving 54 vertebra fracture（48 burst fracture）, 13 appendix fracture, 1 joint dislocation ,22 fragment protruded into vertebral canal, 3 high density hematoma in vertebral canal and 22 spinal cord compression. Conclusions X-ray plain film is valuable in the diagnosis of thoracolumbar bursting fracture. CT is superior to plain film in revealing spine three-pole structure, appendix fracture, spinal stenosis,protrusion of intervertebral disk and the injury of spinal cord and nerve root.