脊柱创伤椎管容积测量的意义

The significance of measurement of vertebral canal volume for spinal injury.

目的 探讨脊柱创伤后椎管容积变化的测量方法以及椎管容积下降对脊髓功能的影响 ,分析椎管横截面积下降与椎管容积下降的相关关系。方法 本组 17例 ,男 13例 ,女 4例。年龄16 - 5 9岁 ,平均 43岁。骨折节段 :T1 2 3例 ;L1 7例 ;L2 6例 ;L3 1例。脊髓功能判定 (Frankel法 ) :A级 1例 ;B级 1例 ;C级 6例 ;D级 2例 ;E级 7例。应用 Philips螺旋 CT扫描骨折部位 ,在 Easy Vision工作站分别计算椎管横截面积下降率和椎管容积下降率 ,并进行图像三维重建 ,选择不同的切割方法 ,消除遮盖视野的组织结构 ,使椎管内骨块的立体图像清晰显示出来。我们用 AVH三个参数反映椎管狭窄程度 :A(area)—椎管横截面积下降率 ;V(volum e)—椎管容积下降率 ;H(height)—椎管狭窄的纵径。结果 椎管横截面积下降率为 5 0 %～ 91.3%,平均 6 3%;椎管容积下降率为2 8.2 %～ 79.5 %,平均 49%;椎管狭窄纵径 8m m～ 15 mm ,平均 12 .4m m。经统计学处理 ,椎管容积下降率与椎管横截面积下降率的相关性具有非常显著性意义 (P<0 .0 1)。结论 脊柱创伤后测量椎管容积的意义 ,一是有利于医生从空间而不是平面概念上理解和分析椎管狭窄对脊髓的影响 ;二是有利于对椎管狭窄程度作容积性的定量分析 ;三是有利于更加科学、合理地选择治疗方?

Objective To study the significance and methods of measuring volume of vertebral canal in spinal injury,and the relative relationship of the decline of vertebral canal volume and the decline of cross section area with the Spiral CT.Methods 17 patients suffered from burst fracture between T 12 to L 3 were included in this study.There were 13 males and 4 females,aged from 16 to 59 years old,average 43 years.1 patient was classified as Frankel grade A,1 patient as grade B,6 patients as grade C,2 patients as grade D,and 7 patients as grade E.All patients received the Spiral CT scan at the fracture location.All data were transferred to the Easy Vision Workstation for three-dimensional reconstruction.The decline rate of the cross section area and the vertebral canal volume were calculated.We showed vertebral canal narrow with AVH.A(area)-the decline rate of cross section area;V(volume)-the decline rate of vertebral canal volume;H(height)-the height of vertebral canal narrow.Results The decline rate of cross section area ranged from 50% to 91.3%,with an average of 63%;The decline rate of vertebral canal volume ranged from 28.2% to 79.5%,with an average of 49%;The height of vertebral canal narrow ranged from 8mm to 15mm,with an average of 12.4mm.There were marked relative relationship between the decline rate of vertebral canal volume and of cross section area (P<0.01).Conclusion This study indicate that measurement of vertebral canal volume are significant as following:1) It is advantageous to analyse harmful influence of spinal cord wound by vertebral canal volume decline.2)Quentitative analysis of vertebral canal volume decline rate were provided.3)More reasonable treatment methods may be selected by doctors.