脊柱压缩性、爆裂性骨折的X线平片及CT的诊断价值

目的探讨X线平片、CT检查对脊柱压缩性缩性、爆裂性骨折的诊断价值。方法收集我院2005年2月-2008年11月间136例胸腰椎压缩性、爆裂性骨折病例，观察分析X线平片及CT上的脊柱骨性结构、椎管损伤情况。结果X线平片上136例患者127例显示胸腰椎压缩性、爆裂骨折，其中14例椎管内见明确小骨片（10％）；9例未见明确骨折征象。CT上全部病例可见椎体粉碎骨折。40例前柱骨折；22例椎体中柱骨折；25例后柱骨折；脊柱前、中两柱同时骨折23例：前、中、后三柱同时骨折26例。结论CT检查更能显示脊柱压缩性、爆裂性骨折中骨折碎片、脊椎前，中，后柱损伤的详情，临床上要重视X线平片及cT检查的互补作用。

Diagnostic value of X-ray plain film and CT in spinal compressed and burst fractures Huang

Objective To investigate the diagnostic value of X-ray plain i-tim and computed tomography in spinal compressed, burst fractures. Methods 136 patients with spinal compressed, burst fractures at thoracic or lumbar levels were enrolled during Feb. 2005 to Nov. 2008. The spinal column manifestations on X-ray plain film and computed tomography were analyzed, including the intact of spinal bone and vertebral canal. Results On X-ray plain film, 127 of 136 patients had thorax or lumbar vertebral compressed, burst fracture, 14（10%） of them had bone fragment in their vertebral canal of injured level. No bone fracture was found in the rest 9 patients. On computed tomography, there was vertebral comminuted fracture in all patients. Among the 136 patients, 40 had anterior column fracture, 22 middle column fracture, 25 posterior column fracture, 23 anterior and concurrent middle column fractures, 26 all three column fractures. Conclusion CT could demonstrate the details of bone fragment, anterior, middle and posterior column injury involved in the spinal compressed, burst fracture. X-ray plain film and computed tomography should be complementarily used in clinical practice.