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[运用节段性原则对脊柱损伤进行临床与放射学的法律评估]

[Clinical and radiologic legal assessment of spinal injuries using the segmental principle].

作者信息

Weber M, Wimmer B

机构信息

Orthopädische Abteilung, Chirurgischen Universitätsklinik Freiburg.

出版信息

Unfallchirurgie. 1991 Aug;17(4):200-7. doi: 10.1007/BF02588687.

Abstract

Cat scanning of the traumatized spine led to an approved classification of different types of lesions. Its application is important--not only for therapeutic reasons but also for the judgement of the end results. The classification enables the definition of a remaining instability (radiological and clinical) and is useful for the evaluation of the prognosis according to the structural changes within the motion segments. The conventional way of appreciating working capacity is no longer satisfying considering the improved diagnostic tools and the increasing frequency of various deformities, instability and even ankylosis and their combinations. As in the evaluation of peripheral joint function a concept is proposed, which is based on the structural changes in the motion segments and their motility. According to the kind and amount of deformity and instability the segment value is multiplicated with factors 1 to 6. The number of involved segments is added to obtain the definite range of working capacity. The concept is practicable in all parts of the vertebral column and allows a differentiated judgement within the usual percentages.

摘要

对创伤性脊柱进行计算机断层扫描可对不同类型的损伤进行认可的分类。其应用很重要——不仅出于治疗原因,还用于判断最终结果。该分类能够定义残留的不稳定性(影像学和临床方面),并有助于根据运动节段内的结构变化评估预后。考虑到诊断工具的改进以及各种畸形、不稳定性甚至强直性脊柱炎及其组合的频率增加,传统的评估工作能力的方法已不再令人满意。如同在评估外周关节功能时一样,提出了一个基于运动节段结构变化及其活动度的概念。根据畸形和不稳定性的种类及程度,将节段值乘以1至6的系数。将受累节段的数量相加,以获得工作能力的明确范围。该概念在脊柱的所有部位都可行,并能在通常的百分比范围内进行差异化判断。

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