CT在胸腰椎骨折诊治中的作用

The value of CT for diagnosis and treatment in thoracolumbar fracture

目的:探讨CT在胸腰椎骨折患者诊断、分型、制定治疗方案、选择椎弓根钉等方面的作用。方法:160例胸腰椎骨折患者进行常规体检、X线、CT扫描,按照CT显示椎管压迫部位及方向,采取相应的治疗。结果:①既无神经症状又无椎管压迫的经保守治疗获痊愈;②无神经症状而有椎管明显受压的选择减压、内固定术,远期未见神经症状;③爆裂型骨折伴不全瘫,采用前或后方减压、内固定,术后神经功能提高2～3级;④爆裂型骨折伴全瘫,采用有限度后方减压、内固定,可缩短卧床时间。结论:CT扫描在胸腰椎骨折患者合并或不合并脊髓压迫的诊断治疗中,提供了极为重要的指导作用,并为椎弓根钉的选择与盲视下置入提供依据。

Objective:To investigate the value of CT in the diagnosis,typing,choice of pedicle screw and treatment planning of thoracolumbar fracture.Materials and Methods:Routine physical examinations,radiography,and CT were per-formed in160patients who had thoracolumbar fractures.Correspondent treatments were adopted according to the place and direction of canal compression revealed by CT scan.Results:①Seventy-three patients without symptoms and neural canal compression were cured by conservative treatments.②Decompression and internal fixation were performed in5patients with-out neural symptoms but with obvious vertebral canal compression.③Anterior or posterior decompression and internal fixation were used in61partial paralytic patients with thoracolumbar burst fracture.After treatment neural function was improved2to3degrees.④The time of bedding was shortened after limited posterior decompression,and internal fixation for 26complete paralytic patients with thoracolumbar burst fracture.Con clusion:CT scanning plays a significant role in the diagnosis and treat-ment of thoracolumbar fracture with or without vertebral canal compression,and provide evidence for the choice and blind insertion of pedicle screw.