胸腰椎骨折后方韧带复合体损伤的MRI诊断及危险因素分析

目的 探讨胸腰椎骨折后方韧带复合体损伤的MRI诊断方法与效果，分析胸腰椎骨折后方韧带复合体损伤发生的危险因素。方法 2012年4月~2015年4月选择在笔者医院骨科诊治的80例胸腰椎骨折患者，都进行MRI诊断与手术探查确诊。结果 MRI诊断为后方韧带复合体损伤28例，手术所见后方韧带复合体损伤30例，为此胸腰椎骨折后方韧带复合体损伤的MRI诊断敏感度与特异性分别为93.3%和100.0%。随着后方韧带复合体损伤程度的增加，脊髓损伤百分比明显增加，对比差异有统计学意义（P<0.05）。多因素Logistic回归分析显示体重指数、腰椎间盘病变和骨赘为导致后方韧带复合体损伤发生的主要独立危险因素（P<0.05）。结论 胸腰椎骨折后方韧带复合体损伤比较常见，体重指数、腰椎间盘病变和骨赘为主要的危险因素，MRI诊断具有很好的敏感度、特异性，能有效反应损伤程度，值得在临床上推广应用。

MRI Diagnosis for the Thoracic and Lumbar Fractures Posterior Ligamentous Complex Injury

Objective To investigate the MRI diagnosis methods and its effects for the thoracic and lumbar fractures posterior ligamentous complex injury, and analysis the risk factors of thoracic and lumbar fractures posterior ligamentous complex injury. Methods From April 2012 to April 2015 in our hospital, we selected 80 thoracolumbar fracture patients. All patients were given MRI diagnosis and surgical exploration confirmation. Results Posterior ligamentous complex injury by MRI diagnosis were 28 patients, and rear ligament complex by surgical findings were 30 patients, so the MRI diagnostic sensitivity and specificity for the thoracic and lumbar fractures posterior ligamentous complex injury were 93.3% and 100.0%. With the degree of posterior ligamentous complex injury increasing, the percentage of spinal cord injury were significantly increased. The difference was statistically significant (P<0.05). Multivariate Logistic regression analysis showed that body mass index (BMI), waist disc disease and osteophytes were the major independent risk factors for the posterior ligamentous complex injury (P<0.05). Conclusion Thoracic and lumbar fractures posterior ligamentous complex injury is more common, BMI, waist disc disease and osteophytes are the main risk factors. MRI diagnosis has good sensitivity and specificity.The degree of damage can be an effective response that worth for the clinical application.