胸腰椎爆裂性骨折的影像学诊断与分类

目的 :进一步讨论胸腰椎爆裂性骨折的影像学诊断和分类。方法 :回顾性分析了 12 6例 13 9处胸腰椎爆裂性骨折 ,依据Atlas标准进行分类并比较其稳定性 ,对照了三种影像学诊断方法的优势及不足。结果 :Atlas分类A型 14例次 ,B型 79例次 ,C型 11例次 ,D型 19例次 ,E型 16例次。X线平片能发现大多数胸腰椎爆裂性骨折 ,但易漏诊、误诊 ;CT可准确显示椎体后缘、游离骨折片或椎间盘凸入椎管的程度 ;MRI能清晰显示韧带、椎间盘和脊髓变化。结论 :对怀疑或X线已诊断的胸腰椎骨折应常规作CT检查 ,MRI可作为判定脊髓损伤程度的补充。

Radiological Diagnosis and Classification of Thoracolumbar Burst Fractures

Objective: To discuss further radiological diagnosis and classification of thoracolumbar burst fractures.Method:126 patiens with 139 thoracolumbar burst fractures were restrospectively reviewed.Plain radiographic were taken in all cases,CT and MRI were available in 110 and 87 cases respectively.Classification of these fractures were obtained according to Atlas'criteria,and stability compared,advantage and deficiency contrasted simultaneously.Result:Model A 14 cases,Model B 79 cases, Model C 11 cases,Model D 19 cases and Model E 16 cases.Plain radiographs can find most thoracolumbar burst fractures;CT was able to show accurately the extent protruding to vertebral canal of centrum back,dissociate fracture pieces and intravertebral disk.MRI could not only clearly display injured ligament,vertebral disk and spinal cord,but also provide credible gists for choosing correct treatment plans.Conclusion:CT scanning should be routinely indicated to suspicious spinal fractures or diagnosed fractures by Xray.MRI could be considered a effective complement when approving injuried degree of spinal cord.