Schnake K J, von Scotti F, Haas N P, Kandziora F
Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Deutschland.
Unfallchirurg. 2008 Dec;111(12):977-84. doi: 10.1007/s00113-008-1503-z.
Type B injuries of the thoracolumbar spine (AO classification) indicate the need for surgical treatment. Type B1 injuries include disruption of the posterior ligament complex (PLC), which can be underdiagnosed when using x-ray and CT. The aims of this study were to determine the frequency of misclassification to compile similarities of type B1 injuries.
Retrospective study evaluating 361 fractures.
Initially, 39 (41.9%) of 93 type B injuries were misdiagnosed as type A. 59% of 93 injuries belonged in the type B1 category. 29% of these showed no radiological signs of a PLC injury. Among the remaining cases, the following signs were the most frequently seen: vertebral segmental angle >15 degrees (44%), pronounced compression of vertebral cancellous bone despite minimal (<50%) reduced anterior vertebral height (41%), and a considerably reduced anterior vertebral height to <50% (31%).
Type B injuries are frequently misinterpreted. To achieve a correct diagnosis, all clinical and radiological signs must be considered. 29% of all type B1 injuries cannot be detected on x-ray or CT scan.
胸腰椎B型损伤（AO分类）表明需要手术治疗。B1型损伤包括后韧带复合体（PLC）断裂，使用X线和CT检查时可能漏诊。本研究的目的是确定误诊频率，以汇总B1型损伤的相似性。
回顾性研究，评估361例骨折。
最初，93例B型损伤中有39例（41.9%）被误诊为A型。93例损伤中59%属于B1型。其中29%未显示PLC损伤的放射学征象。在其余病例中，最常见的征象如下：椎体节段角>15度（44%），尽管椎体前缘高度减少最小（<50%）但椎体松质骨明显压缩（41%），以及椎体前缘高度明显减少至<50%（31%）。
B型损伤常被误诊。为了做出正确诊断，必须考虑所有临床和放射学征象。所有B1型损伤中有29%在X线或CT扫描上无法检测到。
