多节段脊柱骨折的诊断表述与手术治疗

目的　探讨多节段脊柱骨折 (MSF)的诊断表述与手术治疗。方法　总结Scofix器械治疗的 4 6例MSF ,按ASIA分级、感觉运动评分、伤椎椎体中央高度及后凸畸形矫正率进行临床分析。结果　 4 6例MSF ,累及椎体 10 0个节段 ,关键损伤部位骨折类型以爆裂骨折和骨折脱位为主 (82 .6 % )。平均随访 2 .5年。脊髓不完全性损伤病例的ASIA分级分别提高了 1～ 2级 ,感觉运动评分行t检验 ,B、C级术前与随访时比较有显著性差异 (P <0 .0 5 ) ;脊髓完全性损伤病例 (A级 )的ASIA分级无改善 ,感觉运动评分未达到显著性差异 ,但分别平均提高 19.3分和 15 .9分。结论　MSF的诊断表述应明确多节段骨折的关键部位及骨折的性质 (按关键损伤部位排序 )、脊髓损伤的程度 ,以便于临床比较 ;固定节段应根据骨折类型 ,选择不同的固定节段。

The diagnostic expression and surgical treatment of multiple level spinal fractures

Objective To discuss the diagnostic expression and surgical treatment of multiple level spinal fractures(MSF). Methods 46 cases of MSF treated with Scofix instrument were reviewed retrospectively .The Spinal Injury Association (ASIA) sensory and motor scores were analyzed. Results To the total 46 cases of MSF (related to 100 segments), the follow-up results (in the average of 2.5 years) showed that the ASIA grade improved 1 or 2 grades in the cases among incomplete spinal cord injury (ASIA grade B and C). There was a statistical significant difference ( P <0.05) in the sensory and motor scores compared with that of pre-operation. For the cases among complete spinal cord injury, the ASIA grade could not be improved, but the sensory and motor scores were improved with the average of 19.3 and 15.9 respectively. The internal fixated area should be chose appropriately according to the types of fractures. Conclusion The diagnostic expression should clearly indicate the key location and the characteristic of the fracture. The internal fixated area should be determined appropriately according to the types of fractures of MSF.