Department of Neurosurgery, David Grant Medical Center, Travis Air Force Base, CA, USA.
Spine (Phila Pa 1976). 2009 Oct 15;34(22):2400-5. doi: 10.1097/BRS.0b013e3181b7e585.
Retrospective analysis.
To analyze the types of orthopedic spine fractures sustained by North Atlantic Treaty Organization soldiers when vehicles are attacked by improvised explosive devices (IEDs), with specific focus on the flexion-distraction type thoracolumbar fracture (Chance fracture).
Operation Enduring Freedom is the North Atlantic Treaty Organization's effort in Afghanistan. IED attacks on armored vehicles are common and account for high proportion of soldiers' deaths and injuries.
Retrospective record review was accomplished on soldiers admitted to a military hospital with orthopedic spine fractures after IED attacks on vehicles from January 1, 2008 to May 15, 2008. Thoracolumbar fractures were classified using the McAfee classification system.
Twelve male patients with 16 thoracolumbar fractures were identified (3 patients with multiple fractures). The 16 thoracolumbar fractures included 6 flexion-distraction fractures in 5 patients (38%, 6/16: two T12, two L1, one L3, and one L4), 7 compression fractures in 5 patients (44%, 5/16; one T7, one T8, two L1, one L2, one L3, and one L4), and 3 burst fractures (19%, 3/16; two L1 and one L2).
The incidence of flexion-distraction thoracolumbar (Chance) fractures has been reported to be between 1.0% and 2.5% in most spine fracture series. In this small study, Chance fractures represented 38% of all tho-racolumbar fractures sustained after IED attack on armored vehicles. The blast pattern associated with IED explosion may be responsible for the high rate of these injuries in vehicle occupants.
回顾性分析。
分析北大西洋公约组织（NATO）士兵在车辆遭简易爆炸装置（IED）袭击时所发生的骨科脊柱骨折类型，重点分析屈曲牵张型胸腰椎骨折（Chance 骨折）。
持久自由行动是北约在阿富汗的行动。IED 对装甲车的袭击很常见，且导致了相当比例的士兵伤亡。
对 2008 年 1 月 1 日至 2008 年 5 月 15 日期间因 IED 袭击车辆而住进某军事医院的骨科脊柱骨折士兵进行了回顾性病历记录审查。采用 McAfee 分类系统对胸腰椎骨折进行分类。
确定了 12 名男性患者共 16 例胸腰椎骨折（3 例为多处骨折）。16 例胸腰椎骨折中，5 例患者有 6 例屈曲牵张型骨折（38%，6/16：2 例 T12，2 例 L1，1 例 L3，1 例 L4），5 例患者有 7 例压缩型骨折（44%，5/16：1 例 T7，1 例 T8，2 例 L1，1 例 L2，1 例 L3，1 例 L4），3 例爆裂型骨折（19%，3/16：2 例 L1，1 例 L2）。
在大多数脊柱骨折系列中，屈曲牵张型胸腰椎（Chance）骨折的发生率报告为 1.0%至 2.5%。在这项小型研究中，Chance 骨折在因 IED 袭击装甲车辆而导致的所有胸腰椎骨折中占 38%。与 IED 爆炸相关的爆炸模式可能是导致车内人员此类损伤发生率较高的原因。
