Objective To review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic va-lue of different imaging methods. Methods One hundred and fourteen patients with 120 thoracolumbar b...Objective To review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic va-lue of different imaging methods. Methods One hundred and fourteen patients with 120 thoracolumbar burst fractures were retrospectively reviewed. Pl-ain radiographs were available in all cases; CT scans and MRI were obtained in 96 and 74 cases, respectively. Results A total of 27 burst fractures were misdiagnosed as other types of fractures on radiographs alone, and accounted for 22.5% of all fractures. The results indicated that plain radiographs often fail to delineate the pathological features of thor-acolumbar burst fractures, leading to delay in diagnosis. Conclusion In regard to thoracolumbar injury diagnosis, burst fractures should be differentiated from compression frac-tures. CT should be routinely indicated and MRI examination, when necessary, may be simultaneously considered.展开更多
Radiographic measurements was performed on 124 normal adults for anterior, posterior and middle heights of the vertebral bodies in thoracic and lumbar spine. The normal ratios of vertebral height in one vertebral body...Radiographic measurements was performed on 124 normal adults for anterior, posterior and middle heights of the vertebral bodies in thoracic and lumbar spine. The normal ratios of vertebral height in one vertebral body and one with the adjacent bodies were presented. The method for measurement and its diagnostic value to osteoporotic vertebral fractures were discussed.展开更多
OBJECTIVE: To investigate the mechanism associated with thoracolumbar burst fractures. METHODS: Stress distribution of the spine in the upright, flexion and extension positions was analyzed using a three-dimensional f...OBJECTIVE: To investigate the mechanism associated with thoracolumbar burst fractures. METHODS: Stress distribution of the spine in the upright, flexion and extension positions was analyzed using a three-dimensional finite element model of the spinal motion segment. RESULTS: Stress concentration was noted at the pedicle and posterosuperior part of the vertebral body near the pedicle. CONCLUSION: Stress concentration of the spine may be implicated in the biomechanical mechanism underlying thoracolumbar burst fractures.展开更多
Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation com...Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty （Group A, n=12） or posterior shortening osteotomy （Group B, n=16） for osteoporotic thoracolumbar Kummell＇s disease were analyzed retrospectively. Japanese orthopedic association （JOA） and visual analogue scale （VAS） scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered. Results： The follow-up period was 12-54 months （average 29 months）. Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation （t=-5.306, P〈0.001）. There was no significant difference between Groups A and B （t=0.618,P〉0.05）. The kyphosis were corrected from preoperative 33.9°（A）/ 37.3°（B） to postoperative 10.3°（A）/6.5°（B）, and 15.3° （A）/13.7°（B） at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions： The similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kummell＇s disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.展开更多
文摘Objective To review imaging use in the diagnosis of thoracolumbar burst fractures and to determine the diagnostic va-lue of different imaging methods. Methods One hundred and fourteen patients with 120 thoracolumbar burst fractures were retrospectively reviewed. Pl-ain radiographs were available in all cases; CT scans and MRI were obtained in 96 and 74 cases, respectively. Results A total of 27 burst fractures were misdiagnosed as other types of fractures on radiographs alone, and accounted for 22.5% of all fractures. The results indicated that plain radiographs often fail to delineate the pathological features of thor-acolumbar burst fractures, leading to delay in diagnosis. Conclusion In regard to thoracolumbar injury diagnosis, burst fractures should be differentiated from compression frac-tures. CT should be routinely indicated and MRI examination, when necessary, may be simultaneously considered.
文摘Radiographic measurements was performed on 124 normal adults for anterior, posterior and middle heights of the vertebral bodies in thoracic and lumbar spine. The normal ratios of vertebral height in one vertebral body and one with the adjacent bodies were presented. The method for measurement and its diagnostic value to osteoporotic vertebral fractures were discussed.
基金supported by the National Natural Science Foundation of China(No3880785)
文摘OBJECTIVE: To investigate the mechanism associated with thoracolumbar burst fractures. METHODS: Stress distribution of the spine in the upright, flexion and extension positions was analyzed using a three-dimensional finite element model of the spinal motion segment. RESULTS: Stress concentration was noted at the pedicle and posterosuperior part of the vertebral body near the pedicle. CONCLUSION: Stress concentration of the spine may be implicated in the biomechanical mechanism underlying thoracolumbar burst fractures.
文摘Objective： To compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Ktimmell＇s disease. Methods： Clinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty （Group A, n=12） or posterior shortening osteotomy （Group B, n=16） for osteoporotic thoracolumbar Kummell＇s disease were analyzed retrospectively. Japanese orthopedic association （JOA） and visual analogue scale （VAS） scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered. Results： The follow-up period was 12-54 months （average 29 months）. Pre- and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation （t=-5.306, P〈0.001）. There was no significant difference between Groups A and B （t=0.618,P〉0.05）. The kyphosis were corrected from preoperative 33.9°（A）/ 37.3°（B） to postoperative 10.3°（A）/6.5°（B）, and 15.3° （A）/13.7°（B） at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation. Conclusions： The similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kummell＇s disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.
