Tisot Rodrigo A, Avanzi Osmar
Department of Orthopaedics and Traumatology, Faculdade de Ciencias Medicas, Irmandade da Santa Casa de Misericordia de Sao Paulo, Brasil.
J Orthop Surg (Hong Kong). 2009 Dec;17(3):261-4. doi: 10.1177/230949900901700302.
To assess the correlation between the presence of lamina fractures, narrowing of the spinal canal, and the severity of injury.
Records of 146 men and 44 women aged 13 to 84 (mean, 39) years diagnosed with burst fractures of the thoracolumbar spine were retrospectively reviewed. The laminar fractures and narrowing of the spinal canal were measured using computed tomography. The severity of injury was determined using the Injury Severity Score (ISS) and the New Injury Severity Score (NISS). The ISS and NISS of patients with and without laminar fractures were compared. The sensitivity and specificity of ISS, NISS, and narrowing of the spinal canal in association with laminar fractures were also compared.
92 (48%) of the patients had laminar fractures. The mean narrowing of the spinal canal was more severe in patients with laminar fractures than those without (47% vs 28%, p<0.001). Patients with laminar fractures had a significantly higher mean ISS (17 vs 12, p<0.001) and NISS (19 vs 13, p<0.001). Narrowing of the spinal canal is more sensitive and specific than the ISS and NISS when correlating laminar fractures.
In patients with burst fractures of the thoracolumbar spine, the presence of laminar fractures indicates a more severe injury.
评估椎板骨折的存在、椎管狭窄与损伤严重程度之间的相关性。
回顾性分析146例男性和44例女性（年龄13至84岁，平均39岁）诊断为胸腰椎爆裂骨折的记录。使用计算机断层扫描测量椎板骨折和椎管狭窄情况。使用损伤严重程度评分（ISS）和新损伤严重程度评分（NISS）确定损伤严重程度。比较有无椎板骨折患者的ISS和NISS。还比较了ISS、NISS以及椎管狭窄与椎板骨折相关的敏感性和特异性。
92例（48%）患者有椎板骨折。有椎板骨折患者的椎管平均狭窄程度比无椎板骨折患者更严重（47%对28%，p<0.001）。有椎板骨折患者的平均ISS（17对12，p<0.001）和NISS（19对13，p<0.001）显著更高。在与椎板骨折相关时，椎管狭窄比ISS和NISS更敏感和特异。
在胸腰椎爆裂骨折患者中，椎板骨折的存在表明损伤更严重。
