后方韧带复合体损伤情况在评价胸腰椎肿瘤致病理性骨折中的作用

The clinical significance of posterior ligament complex injuries in the evaluation of pathological fractures caused by thoracolumbar spine tumors

目的通过分析胸腰椎肿瘤致病理性骨折患者的后方韧带复合体(PLC)损伤情况,研究其在胸腰椎肿瘤致病理性骨折损伤程度、骨折分型、损伤评分、后凸畸形及神经功能损伤中的作用。方法选取胸腰椎肿瘤致病理性骨折患者90例,根据PLC损伤程度将患者分为PLC完整组和PLC损伤组。通过评判两组患者的骨折分型、损伤评分、后凸畸形及神经功能损伤情况,研究各指标与PLC损伤的关系。结果 PLC损伤组的载荷分享评分(LSC)和胸腰椎损伤严重程度评分(TLICS)均高于PLC完整组(P﹤0.01),Cobb角度大于PLC完整组(P﹤0.01)。PLC损伤组患者的Denis分型和AO分型均较PLC完整组严重。PLC损伤组和PLC完整组的神经功能不全比例分别为88.89%、60.00%,差异有统计学意义(P﹤0.01)。结论胸腰椎肿瘤致病理性骨折与PLC损伤情况关系密切。

Objective To analyze posterior ligament complex（PLC） injuries in patients with pathological fractures caused by thoracolumbar spine tumors, and its relation to the injury degree, fracture subtype, injury score, kyphosis and nerve function damage of pathological fractures caused by thoracolumbar spine tumors. Method In this study, 90 pa-tients with pathological fractures caused by thoracolumbar spine tumors were selected. According to the injury degree of PLC, the subjects were divided into two groups：PLC intact group and PLC injury group. The relation between PCL inju-ries and fracture indices such as fracture subtype, injury score, kyphosis and nerve function damage were explored by the analysis of these indices. Result The load-sharing classification （LSC） score and thoracolumbar injury classification se-verity score （TLICS） of PLC injury group were greater than those of PLC intact group （P〈0.01）, and the Cobb angle of in-jury group was greater than that of intact group （P〈0.01）. The fracture type according to Denis classification and AO clas-sification in PLC injury group was more advanced than that in PLC intact group. The percentage of nerve function dam-age in PLC injury group and PLC intact group was 88.89%and 60.00%respectively, and the difference reached statistical significance （P〈0.01）. Conclusion The pathological fractures caused by thoracolumbar spine tumors are closely related to the PLC injuries.