胸腰段椎体压缩性骨折中下腰痛症状观察及机制分析

Mechanism of lumbobosacral pain in thoracolumbar vertebral compression fractures

目的探讨下腰痛症状在胸腰段椎体压缩性骨折中的诊断意义,并探讨其发生机制。方法回顾2002年1月~2009年12月收治的胸腰段椎体压缩性骨折患者392例,观察有无骨折局部疼痛症状及下腰痛症状。前瞻观察2010年1月~2011年12月急诊收治的〉70岁低能量腰部外伤患者369例,考察胸腰段椎体压缩性骨折的发生率。结果回顾性观察392例患者中,仅有骨折局部痛205例（52.3%）,仅有下腰痛77例（19.6%）,二者均有110例（28.1%）。前瞻性观察369例中94例确诊为胸腰段椎体压缩性骨折,占受伤总人数24.0%。结论下腰痛症状对胸腰段椎体压缩性骨折的诊断有重要的临床意义,其发生机制是腰椎传入神经的传导通路和牵涉痛原理。

Objective To investigate the diagnostic significance of lumbosacral pain in thoracolumbar vertebral compression fractures,and to explore its mechanism. Methods A retrospective study was performed of 392 patients with thoracolumbar vertebral compression fracture from January 2002 to December 2009. The presence of local pain and lumbosacral pain of these patients were recorded. A prospective observational study was performed of 369 old patients with low energy injury of from January 2010 to December 2011. The incidence of thoracolumbar vertebral compression fracture of these patients were calculated. Results Of the 392 patients in retrospective study,205 patients（ 52. 3%） suffered only local fracture pain,77patients（ 19. 6%） suffered only lumbosacral pain,110 patients suffered both local fracture pain and lumbosacral pain（ 28. 1%）. In the prospective study,94 patients（ 24. 0 %） were diagnosed as thoracolumbar vertebral compression fractures.Conclusion The lumbosacral pain is very important for diagnosis of thoracolumbar compression fracture diagnosis. The mechanism may be determined by the principle of the lumbar afferent nerve pathway and referred pain.