Study Design: Retrospective, diagnostic study. Objective: To verify if the interspinous distance is able to predict the risk for kyphotic collapse in thoracolumbar burst fractures treated conservatively without neurol...Study Design: Retrospective, diagnostic study. Objective: To verify if the interspinous distance is able to predict the risk for kyphotic collapse in thoracolumbar burst fractures treated conservatively without neurological deficit. Summary of Background Data: In patients with thoracolumbar burst fractures, the association between the amount of comminution, by using load-sharing classification (LSC), and kyphotic collapse is presented in the literature. However, LSC does not include the interspinous distance as an indirect sign to suggest biomechanical instability due to posterior ligamentous disruption in these patients in order to predict kyphotic collapse. Methods: We added the interspinous distance to the load-sharing classification (MLSC) in 50 consecutive patients with thoracolumbar burst fractures (according to Denis criteria) treated conservatively. Results: The LSC score was correlated to kyphotic collapse in the patients treated with TLSO (r = 0.312, p = 0.027;Spearman test;A = 0.668). The MLSC was similarly correlated to kyphotic collapse among TLSO-treated patients (r = 0.295, p = 0.038;Spearman test;A = 0.652). Conclusions: The interspinous distance did not contribute to the identification of worse radiographic outcomes, represented by the kyphotic collapse. This may suggest that the amount of comminution pointed out by the LSC is enough and more important than the interspinous opening in order to predict kyphotic collapse in thoracolumbar burst fractures. Possibly, the interspinous distance is much too heterogenous and multifactorial to be useful, since it reflects vertebral body height, preinjury anatomy, as well as posterior element disruption.展开更多
Objective: To compare the characters and outcomes of patients injured from traffic accidents in different rank hospitals. Methods: From 8 hospitals of ranks I III, 1?915 cases were sampled and divided into 4 groups. I...Objective: To compare the characters and outcomes of patients injured from traffic accidents in different rank hospitals. Methods: From 8 hospitals of ranks I III, 1?915 cases were sampled and divided into 4 groups. Injuries of all patients were accessed by the method of RTS, AIS ISS AP and ASCOT. Results: (1) The higher rank of hospitals, the severer the patients condition were. Mean ISSs in hospital ranks II and III were greater than 16, which were recommended as a standard of severe trauma. (2) Transportation of severe patients to high level hospitals prolonged the pre hospital duration by 5 9 h. (3) Factors contributing to death were the trauma severity, complications, hospital ranks that reflect the quality of the medical care. Conclusions: (1) This sample of 1?915 cases matches the condition of most Chinese hospitals in characteristics of traffic trauma patients. (2) Most Chinese hospitals can be divided into 3 degree of trauma center by a criteria of ISS and the unexpected death. (3) Incidence of multiple injuries shows no significant difference in each rank of hospitals. (4) The relationship between the hospital rank and the quality of trauma care is significant. We suggest that a RTS=11 or ISS=9 be triaged to trauma center, and a 10% Ps (survival probability) less than the average Ps of a hospital be triage to higher level hospitals.展开更多
文摘Study Design: Retrospective, diagnostic study. Objective: To verify if the interspinous distance is able to predict the risk for kyphotic collapse in thoracolumbar burst fractures treated conservatively without neurological deficit. Summary of Background Data: In patients with thoracolumbar burst fractures, the association between the amount of comminution, by using load-sharing classification (LSC), and kyphotic collapse is presented in the literature. However, LSC does not include the interspinous distance as an indirect sign to suggest biomechanical instability due to posterior ligamentous disruption in these patients in order to predict kyphotic collapse. Methods: We added the interspinous distance to the load-sharing classification (MLSC) in 50 consecutive patients with thoracolumbar burst fractures (according to Denis criteria) treated conservatively. Results: The LSC score was correlated to kyphotic collapse in the patients treated with TLSO (r = 0.312, p = 0.027;Spearman test;A = 0.668). The MLSC was similarly correlated to kyphotic collapse among TLSO-treated patients (r = 0.295, p = 0.038;Spearman test;A = 0.652). Conclusions: The interspinous distance did not contribute to the identification of worse radiographic outcomes, represented by the kyphotic collapse. This may suggest that the amount of comminution pointed out by the LSC is enough and more important than the interspinous opening in order to predict kyphotic collapse in thoracolumbar burst fractures. Possibly, the interspinous distance is much too heterogenous and multifactorial to be useful, since it reflects vertebral body height, preinjury anatomy, as well as posterior element disruption.
文摘Objective: To compare the characters and outcomes of patients injured from traffic accidents in different rank hospitals. Methods: From 8 hospitals of ranks I III, 1?915 cases were sampled and divided into 4 groups. Injuries of all patients were accessed by the method of RTS, AIS ISS AP and ASCOT. Results: (1) The higher rank of hospitals, the severer the patients condition were. Mean ISSs in hospital ranks II and III were greater than 16, which were recommended as a standard of severe trauma. (2) Transportation of severe patients to high level hospitals prolonged the pre hospital duration by 5 9 h. (3) Factors contributing to death were the trauma severity, complications, hospital ranks that reflect the quality of the medical care. Conclusions: (1) This sample of 1?915 cases matches the condition of most Chinese hospitals in characteristics of traffic trauma patients. (2) Most Chinese hospitals can be divided into 3 degree of trauma center by a criteria of ISS and the unexpected death. (3) Incidence of multiple injuries shows no significant difference in each rank of hospitals. (4) The relationship between the hospital rank and the quality of trauma care is significant. We suggest that a RTS=11 or ISS=9 be triaged to trauma center, and a 10% Ps (survival probability) less than the average Ps of a hospital be triage to higher level hospitals.
