胸腰椎爆裂型骨折148例

目的探讨胸腰椎爆裂型骨折联合椎板骨折,硬脊膜撕裂与神经损伤特点.方法回顾性分析胸腰椎爆裂型骨折148例;其中并椎板骨折41例,硬脊膜撕裂29例,27例马尾神经嵌夹于椎板骨折间隙;无椎板骨折的107例中,硬脊膜撕裂2例.经统计学处理,两组差别有显著意义(P＜0.01).结果胸腰椎爆裂型骨折,当合并椎板骨折时,易发生硬脊膜撕裂;而硬脊膜撕裂与马尾神经损伤有高度相关性(相关系数r=0.9999,P＜0.01).结论胸腰椎爆裂型骨折联合椎板骨折的特点是存在硬脊膜撕裂的危险,同时有神经组织卡压的可能.后路手术可能是较好的选择.

Dural laceration occurring with burst fractures and associated laminar fractures: an analysis of 148 cases

Objective: To explore the characteristics of the injuries in thoracolumbar burst fractures occurring with laminar fractures and associated dural laceration. Methods: The 148 cases in which burst fractures of the thoracic or lumbar vertebrae were treated with posterior instrumentation and arthrodesis for two weeks after the injuries were retrospectively reviewed. There were 41 cases of associated laminar fractures, 29 cases of dural laceration, 27 cases of neural elements entrapped between the fragments from the laminar fracture and 2 cases of dural laceration among the remaininy 107 patients who did not have laminar fracture (P<0.01) Results: Statistical analysis revealed there was significant association of dural laceration with laminar fracture and neural injuries(P<0.01). Conclusion: The presence of preoperative neural injuries in the patient whose burst fracture is complicated with laminar fracture predicts a risk of posterior dural laceration with entrapped neural elements in radiodiagnosis. A posterior operation can be used in such patients very effectively.