Silvestro C, Francaviglia N, Bragazzi R, Piatelli G, Viale G L
Department of Neurosurgery, University of Genoa Medical School, Italy.
J Spinal Disord. 1991 Mar;4(1):49-53.
The predictive value of radiological signs for the presence of lacerations of the thoracolumbar dura in spine-injured patients could represent an important adjunct to the rationale for the optimal management, owing to the possible onset of early or delayed complications of these lesions. Occurrence of signs assumed to be related to dural tears, such as separation of the pedicles, fractures of the laminae, and encroachment of the spinal canal, was analyzed in a consecutive series of 25 patients submitted to surgical reduction and stabilization of the fractured lower thoracic or lumbar spine in a 24-month period. No statistically significant correlation was found between dural lacerations and any of the examined signs. Leaks of cerebrospinal fluid through traumatic breachs of the meninges were found in 16 of the 25 cases. The high rate of occurrence of dural lesions associated with fractures of the lower thoracic or lumbar spine adds a further argument to the aggressive approach to these injuries.
对于脊柱损伤患者胸腰段硬脊膜撕裂的存在，放射学征象的预测价值可能是优化治疗方案合理性的重要辅助手段，因为这些损伤可能会引发早期或延迟并发症。在连续25例于24个月内接受手术复位及固定下胸椎或腰椎骨折的患者中，分析了假定与硬脊膜撕裂相关的征象的出现情况，如椎弓根分离、椎板骨折和椎管受压。未发现硬脊膜撕裂与任何所检查的征象之间存在统计学显著相关性。25例中有16例发现脑脊液通过外伤性脑膜破裂处漏出。下胸椎或腰椎骨折相关硬脊膜损伤的高发生率为积极处理这些损伤提供了进一步的依据。
