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纸质出版:2016
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陈飞,蒲春明,马杰,罗翼.影响胸腰椎爆裂骨折间接复位的相关因素分析[J].陆军军医大学学报(原第三军医大学学报),2016,38(17):1968-1971.
Chen Fei,Pu Chunming,Ma Jie,Luo Yi.Influencing factors for reposition of bone fragment in thoracolumbar burst fracture: analysis of 62 patients[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(17):1968-1971.
目的 明确在胸腰椎椎体爆裂骨折中正中椎管矢状径压缩比率、后突骨折块翻转角度对后突骨折块复位的影响。方法 回顾性分析2010-2014年本科收治的62例单个胸腰椎椎体爆裂骨折患者的临床资料。根据患者术中C臂透视结果分为复位组34例和未复位组28例。骨折采用AO分型,神经损伤采用ASIA分级。根据术中测量伤椎平面椎管正中矢状径压缩比率、后突骨折块翻转角度并进行统计学分析。结果 未复位组椎管正中矢状径压缩比率[(59.8±20.6)%]与复位组[(18.1±11.3)%]比较,差异有统计学意义(t=9.581,P0.01);未复位组后突骨折块的翻转角度[(38.1±18.7)°]与复位组[(21.7±11.6)°]比较,差异有统计学意义(t=4.041,P0.01)。Logistic回归分析结果显示,AO骨折分型(Wald=6.415,P0.05)及椎管正中矢状径压缩比率(Wald=5.417,P0.05)与后突骨折块复位有有关;ASIA分级(Wald =3.816,P0.05)及术前骨折块翻转角度(Wald=0.421,P0.05)与后突骨折块复位无关。结论 椎管正中矢状径压缩比率及骨折的AO分型是胸腰椎爆裂骨折中后突骨折块能否复位的重要评估指标。
Objective To determine the effect of midsagittal canal compromise correlation and rotation angle of bone fragments on the reposition of bone fragment after thoracolumbar burst fracture. Methods A retrospective analysis was carried out on 62 patients with single thoracolumbar burst fracture admitted in our department from 2010 to 2014. According to the results of C-arm X-ray system during the operation
the patients were divided into the reposition group (n=34) and non-reposition (n=28). The fractures were classified according to AO classification. Neurological status was evaluated according to the ASIA grade. The rotation angle of bone fragment and calculates the mid-sagittal canal compression ratio were analyzed. Results There were significant differences in the mid-sagittal canal compression ratio between the reposition group and the non-reposition [(18.1±11.3)% vs (59.8±20.6)%
t=9.581
P0.01]
and in the rotation angles of bone fragments [(38.1±18.7)° vs (21.7±11.6)°
t=4.041
P0.01]. Logistic regression analysis indicated that AO classification (Wald=6.415
P0.05) and midsagittal canal compression ratio (Wald=5.417
P0.05) were correlated with the reposition of bone fragments
while ASIA grade (Wald=3.816
P0.05) had no such correlation. Conclusions AO classification and mid-sagittal canal compression ratio are predictors of assessing the reposition of bone fragments in the thoracolumbar fractures.
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