72例胸腰段爆裂性骨折患者神经功能缺失与伤后椎管狭窄相关性的研究

Study of the correlation between neurologic deficit and traumatic spinal stenosis in 72 cases with thoracolumbar fracture

目的：研究胸腰段爆裂性骨折患者脊髓损伤程度与相应椎管狭窄两者间的相关性。方法：对1998年6月～2004年3月间收治的72例胸腰段爆裂骨折患者进行回顾性分析，脊髓功能按照Frankel分级进行评定，使用透明毫米尺对患者CT片椎管正中矢状径进行测量以此代表椎管面积，分别计算T11、T12、L1、L2四个节段两者的相关系数并进行直线相关分析。结果：T1、T12、L1、L2节段两者问相关系数分别为：O．3348、0．8457、0．6691、0．3336。提示T12水平两者具有较高的相关性，而在L1、L2节段两者的相关性较低。对相关系数进行显著性检验，结果显示在T12、L1椎管狭窄和脊髓功能损伤之间具有直线相关关系（P〈O．001），而在T11、L2两个节段不能认为椎管狭窄和脊髓功能损伤间具有直线相关关系（P〉0．5，0．10〈P〈0．20）。结论：脊髓的损伤程度与椎管狭窄程度具有相关性。测量患者胸腰段爆裂骨折CT扫描图像中椎管占位面积的大小可以作为神经损伤程度的一个预测因素。

Objective To establish the correlation between spinal stenosis after injury and neurologic deficit of the thoracolumbar burst fracture. Methods 72 cases admitted to our hospital were reviewed from June 1998 to March 2004. Neurulogic deficit was classified according to Frankel classification. A transparent millimetrum ruler was used to measure the midsagittal diameter, which represent the spinal canal. Statistical analysis including descriptive analysis and Pearson correlation was performed at different level of the spinal. Results The statistical results were T12 （ r = 0.8457） 〉 L1 （ r = 0. 6691 ） 〉 T11 （ r = 0. 3348 ） 〉 L2 （ r = 0. 3336）, which indicate that the correlativity between spinal narrowing and neurologic deficit at level of T12 is significant. The test of significance indicates that the relationship of liner correlation exists between spinal stenesis after injury and neurologic deficit at the level of T12, L1. Conclusion The measurement of the average sagittal diameter of CT is a predictive factor for the risk of neurulogic involvement after thoracolumbar burst fracture.