胸腰椎爆裂性骨折的X线和CT诊断价值

目的:探讨胸腰椎爆裂性骨折在X线平片和CT片中的诊断价值.方法:对50例急性胸腰椎外伤患者的X线平片和CT片表现特点进行回顾性分析,其中胸椎13例,腰椎35例,胸腰椎2例;男28例,女22例,年龄为17～71 岁,平均年龄41岁.外伤后全部拍摄X线正侧位片及CT平扫,其中7例行CT冠矢状位重建.结果:50例急性脊柱外伤中X线平片清楚显示椎体骨折32例34个椎体为爆裂性骨折,CT清楚显示椎体骨折50例54个椎体骨折(48个椎体为爆裂性骨折),附件骨折13例,小关节脱位1例,见到骨折片突向椎管内22例,椎管内高密度血肿3例,脊髓或神经受压22例.结论:X线平片对胸腰椎爆裂性骨折的诊断有一定价值,CT在显示脊柱三柱结构、附件骨折、椎管狭窄、椎间盘突出、脊髓及神经根损伤等细节方面优于X线平片.

Diagnostic usage of X-ray and CT scan in thoracolumbar burst fracture

Objective To evaluate the diagnostic value of X-ray and CT in thoracolumbar bursting fracture.Methods The plain film and CT findings of acute thoracolumbar injury were retrospectively analyzed in 50 cases,of which were 13 cases of thoracic vertebra,34cases of lumbar vertebra,and 2 of thoracolumbar vertebra.(28 males and 22 females,aged 17 ~ 71with a mean of 41 years).X-ray and CT scan were performed in all patients after injury.Coronal and sagittal plannar reconstruction were performed in 7cases.Results In 50 cases,plain film revealed 32 cases with 34 burst fracture,CT findings revealed 50 patients involving 54 vertebra fracture(48 burst fracture),13 cases of appendix fracture,1case of joint dislocation,22 cases of fragment protruded into vertebral canal,3 cases of high density hematoma in vertebral canal,and 22 cases of spinal cord compression.Conclusion Plain film is valuable in diagnosis of thoracolumbar bursting fracture,but CT is superior to plain film in revealing spine three pole structure,appendix fracture,spinal stenosis,protrusion of intervertebral disk,and injury of spinal cord and nerve root.