胸腰段和腰椎椎体矢状骨折线的CT影像学分析

CT radiographic study of sagittal fracture line in thoracolumbar and lumbar bodies

目的:探讨胸腰段和腰椎椎体矢状骨折线的走行规律及其与椎弓根的关系,为经椎管手术入路减压、椎体内植骨提供指导。方法:对86例(93椎)胸腰段和腰椎骨折椎体行CT及三维重建,观察和分析椎体矢状骨折线的分布、走行规律以及与椎弓根高度区间的关系。结果:93个伤椎椎体中有89个可见椎体矢状骨折线,且矢状骨折线与椎体后壁相通,椎体矢状骨折线绝大多数位于椎弓根所对应的高度区间内。结论:存在椎体高度丢失的胸腰段和腰椎骨折均存在椎体的矢状骨折线,该骨折线的后端绝大部分位于椎弓根高度区间内。临床可通过该骨折线与椎弓根的关系指导椎管内骨折块复位并进行椎体内植骨。

Objective To investigate the regular pattern of sagittal fracture line in thoracolumbar and lumbar bodies and its relationship with the pedicle of the bodies, and to further provide guidance for decompression and bone grafting with trans-spinal canal operative approach. Methods The distribution and regular pattern of sagittal fracture line in thoracolumbar and lumbar bodies on CT and 3D-reconstruction images were retrospectively observed and analyzed in 86 patients （93 vertebraes） of thoracolumbar and lumbar bodies. And the relationship of the sagittal fracture line with the pedicle height interval was evaluated. Results The sagittal fracture line was found in 89 vertebral bodies which connected with the posterior wall of the vertebral body. The junction of sagittal fracture and the posterior wall of vertebral body were linked in height range of the pedicle in a majority of the patients. Conclusions The junction of sagittal fracture line and the posterior wall of the vertebral body can be found at the juncture between the inner wall of the pedicle with the posterior wall of vertebral body.