骨质疏松非相邻节段下腰椎间盘脊柱骨折的特点

目的:探讨高龄骨质疏松性非相邻腰椎间盘脊柱骨折的流行病学的趋势及损伤特点。方法:收集确诊为高龄骨质疏松性非相邻腰椎间盘脊柱骨折78例患者,对其临床资料结合影像学资料进行回顾性分析,了解骨折的流行病学趋势及损伤特点,以及外科手术的选择。结果:纳入的女性患者明显多于男性, 70～75岁及75～80岁年龄组,女性例数明显多于男性(P0.05)。非相邻腰椎间盘脊柱骨折的损伤因素中,自身体能原因和晕厥所致跌倒男性多于女性(P0.05),路滑不慎摔伤女性多于男性(P0.05)。T_(11)到L_2节段的损伤占65.0%以上。最常用的治疗方法为后路减压植骨内固定术(62例,79.5%),其他的治疗方法为保守治疗(3例,3.8%),前路减压植骨内固定术(4例,5.1%),前后联合入路减压植骨内固术(5例,6.4%),经皮椎体后凸成形术(4例,5.1%)。后路减压植骨内固定术后,采用美国脊髓损伤学会的分级标准进行评定,治疗后A级1例,B级12例,C级16例,D级21例,E级12例。结论:年龄和性别是高龄骨质疏松性非相邻腰椎间盘脊柱骨折的损伤因素,需根据患者具体骨折类型选择合适的手术方式进行治疗。

Characteristics of Lower Lumbar Spine Fractures in Non-adjacent Segments of Osteoporosis

Objective To investigate the epidemiological trends and injury characteristics of osteoporotic non-adjacent lumbar intervertebral disc fractures in the elderly, and to provide clinical evidence for diagnosis and treatment. Methods A retrospective analysis of 78 patients diagnosed with osteoporotic non-adjacent lumbar intervertebral disc fractures was performed. The clinical data of patients in the study were combined with imaging data for retrospective analysis to understand the epidemiology of patients with fractures, the trends and injuries characteristics and surgical options. Results There was signi?cant difference on sex in this study; the number of female patients in the 70 to 75 and 75 to 80 age groups was signi?cantly higher than that in male (P<0.05). In patients with non-adjacent intervertebral disc fractures, more males than females had falls due to physical ?tness and syncope (P<0.05), and more females had falls due to slippery road than males (P<0.05). More than 65.0% of injuries occurred between T11 and L2. The most commonly used method was decompression in clinic. Bone fixation was performed in 62 patients ( 79. 5 %) in this study and was assessed using the American Society of Spinal Cord Injury Standards. The other treatment methods were conservative treatment (3 cases, 3.8%), anterior decompression and bone grafting and internal fixation ( 4 cases, 5 . 1 %), anterior and posterior decompression and bone grafting internal fixation ( 5 cases, 6 . 4 %) and npercutaneous vertebroplasty ( 4 cases, 5 . 1 %). After treatment, there were 1 patients in grade A, 12 patients in grade B, 16 patients in grade C, 21 patients in grade D and 12 patients in grade E. The posterior surgery had good clinical ef?cacy. Conclusion Age and sex are the injury factors of lower lumbar spine fractures in non-adjacent segments of osteoporosis. The appropriate surgical treatment should be selected according to the speci?c fracture types of the patients.