胸腰段爆裂骨折椎管狭窄程度与脊髓损伤关系的研究

Study on the relationship between the spinal stenosis of thoracolumbar burst fracture and spinal cord injury

目的:探讨胸腰段爆裂骨折椎管狭窄程度与脊髓损伤的关系以及后路手术的效果。方法:对66例胸腰段椎体爆裂性骨折患者进行回顾性分析,测量伤椎椎管正中矢状径,并按椎管正中矢状径<40%、40%～59%,>59%依次为Ⅰ、Ⅱ、Ⅲ度,同时按ASIA神经功能分级法记录脊髓损伤程度,比较椎管狭窄程度之间与脊髓损伤的关系,以及后路手术前后椎管正中矢状径、椎体高度的变化。结果:Ⅱ、Ⅲ度两组与Ⅰ度组的脊髓损伤比较差异有统计学意义(P<0.05),Ⅱ、Ⅲ度两组的脊髓损伤比较差异无统计学意义(P>0.05);后路手术前后椎管正中矢状径比较差异有统计学意义(P<0.05),椎体高度恢复理想。结论:胸腰段爆裂骨折椎管狭窄程度与脊髓损伤有相关性,但不能反映脊髓损伤程度。后路手术是创伤小且有效的治疗方法。

Objective：To investigate the relationship between the spinal stenosis of thoracolumbar burst fracture and spinal cord injury and the effect of posterior surgery.Methods：The median sagittal diameter of spinal canal was measured from computer tomography in 66 patients with burst fracture,according to the median sagittal canal diameter 40%,40%～59%,59% wereⅠ,Ⅱ,Ⅲ degree.The neural function of spinal cord injury sorting by ASIA was recorded,the relationship of spinal stenosis and spinal cord injury,the median sagittal diameter of spinal canal and vertebral height before and after surgery were compared.Results：The spinal cord injury in groups of Ⅱ,Ⅲ degree was statistically significant com pared with group ofⅠdegree（P0.05）,there was no statistically significance between group of Ⅱ,Ⅲ degree（P0.05）,there was statistically significant between before and after surgery（P0.05）.Conclusion：There is a relationship between the spinal canal stenosis of thoracolumbar burst fracture and spinal cord injury,posterior surgery is minimally invasive and effective.