胸腰段脊椎爆裂骨折的CT诊断(附70例分析)

CT Diagnosis of Thoracolumbar Burst Fracture (An Analysis of 70 Cases)

目的 研究胸腰段脊椎爆裂骨折的CT表现和椎体后缘的后移碎骨片引起椎管狭窄与神经损伤之间的关系。资料与方法 回顾性分析 70例 72个椎体爆裂骨折的CT表现 ,其中有 2例为 2个脊椎爆裂骨折。所有患者CT扫描层厚、层距均为 5mm。结果 脊椎胸腰段爆裂骨折的CT表现如下 :(1)椎体向心性爆裂 ;(2 )碎骨片向后移位导致椎管狭窄 ;(3)椎基静脉孔垂直矢状向骨折 ;(4)单侧或双侧椎板骨折 ;(5 )部分伴随横突、棘突、关节突和 /或椎体骨折。椎管狭窄的程度与神经损伤有关。结论 CT扫描能很好地显示脊椎爆裂骨折和椎管狭窄的程度 ,是诊断胸腰椎爆裂骨折的重要方法 。

Objective To study CT features of thoracolumbar burst fractures and the relationship between neurologic injury and the severity of spinal canal narrowing caused by retro positioned fracture pieces broken from the posterior border of the vertebral body.Materials and Methods CT findings of 72 thoracolumbar burst fractures in 70 consecutive patients were retrospectively analyzed. Two patients had fractures of two vertebral bodies. Scanning slice thickness of 5mm was used in all patients.Results The following signs were found on CT scan. (1) Concentric burst fracture of the vertebral body. (2) Spinal canal narrowing due to retro positioned fracture pieces. (3) Longitudinal fracture with the fracture line vertical to the vertebrobasilar venous foramen. (4) Fractures of unilateral or bilateral lamina of vertebral arch. (5) Fractures of transverse process, articular process and/or pedicle of vertebral arch were occasionally accompanied. Neurologic deficit was related to the severity of spinal canal narrowing.Conclusion CT scans can clearly display the signs of the thoracolumbar burst fractures and also the severity of spinal canal narrowing, therefore, it plays an important role both in diagnosing thoracolumbar burst fractures and in directing clinical management.