多节段非相邻型脊柱骨折的致伤机制及伤情特点Traumatic mechanisms and conditions of multiple-level noncontinuous spinal fractures(MNSF)
王洪伟;王许可;李长青;周跃;
摘要(Abstract):
[目的]分析多节段非相邻型脊柱骨折的致伤机制及伤情特点,以提高脊柱骨折的预防及诊断水平。[方法]总结2001年5月~2011年5月收治的167例多节段非相邻型脊柱骨折患者资料,其中男89例,女78例,年龄16~89岁,平均51.0岁,并进行致伤机制及伤情特点分析。[结果]167例患者中年龄分布主要集中在40~49岁,占22.8%(38/167)。≤49岁各年龄组段男性人数均较女性多,≥49岁各年龄组段男性人数均较女性少。高坠伤是主要致伤原因,占32.9%(55/167)。167例病例中胸椎+腰椎骨折,胸椎+胸椎骨折,腰椎+腰椎骨折所占比例较高,分别为32.9%(55/167)、22.2%(37/167)、19.2%(32/167)。高坠伤最易导致腰椎节段的跳跃性骨折,摔伤和无明显诱因组最易导致胸椎和腰椎节段的跳跃性骨折,车祸伤和重物砸伤最易导致颈椎和胸椎的跳跃性骨折,生活伤最易导致胸椎节段的跳跃性骨折。按唐三元法,跳跃性骨折分型为A型49例,B型80例,C型38例。高坠伤、车祸伤和重物砸伤导致的神经损伤和合并伤发生率较高。按ASIA脊髓损伤分级,A级、B级、C级、D级分别占13.8%(23/167)、4.8%(8/167)、6.0%(10/167)和17.4%(29/167)。[结论]脊柱跳跃性骨折中,高坠伤是主要致伤因素,胸椎和腰椎是多节段非相邻型脊柱骨折的好发部位,应根据其致伤机制及伤情特点来进行预防及诊断。
关键词(KeyWords): 脊柱骨折;多节段;致伤机制;诊断;预防
基金项目(Foundation): 国家863支撑计划分课题(编号:2011AA030106);; 军队临床高新技术重大项目(编号:2010gxjs072)
作者(Author): 王洪伟;王许可;李长青;周跃;
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