一项关于胸腰椎爆裂骨折中受压区域、骨碎片区域及整个骨折累及区域的影像学研究。

An imaging study of the compressed area, bony fragment area, and the total fracture-involved area in thoracolumbar burst fractures.

作者信息

Wu Ai-Min, Wang Xiang-Yang, Zhao Hao-Zeng, Lin Sheng-Lei, Xu Hua-Zi, Chi Yong-Long

机构信息

Department of Spinal Surgery, Zhejiang Spinal Research Center, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, People's Republic of China.

出版信息

J Spinal Disord Tech. 2014 Jun;27(4):207-11. doi: 10.1097/BSD.0b013e3182a22a77.

DOI:10.1097/BSD.0b013e3182a22a77

PMID:24869983

Abstract

STUDY DESIGN

Imaging study.

SUMMARY OF BACKGROUND DATA

X-ray and computed tomography (CT) sagittal reconstruction images are used to evaluate the stability of the spine. However, we did not know the extent of difference between them.

OBJECTIVE

The aim of the study was to compare the differences seen in thoracolumbar burst fractures on lateral radiographs and CT sagittal reconstruction images and investigate their clinical relevance.

MATERIALS AND METHODS

Lateral radiographs and CT sagittal reconstruction images of 45 patients with thoracolumbar burst fractures were used to record the following measurements: the compressed area of the fractured vertebrae, from lateral radiographs, and the sagittal compressed area, bony fragment area, and total fracture-involved area, from CT sagittal reconstruction images.

RESULTS

The percentage of compressed area of fractured vertebrae was 29.32±13.80% on lateral radiographs and 27.93±12.21% on CT sagittal reconstruction images; there was no significant difference between them (P>0.05). The percentage of total fracture-involved area was 53.20±20.64% on CT sagittal reconstruction images, higher than the compressed area measured on lateral radiographs (P<0.01) and CT sagittal reconstruction images (P<0.01). The percentage of bony fragment area was 25.27±15.18% on CT sagittal reconstruction images; there was no significant relationship between bony fragment area and the compressed area (r=0.1258, P>0.05).

CONCLUSIONS

The compressed area of fractured vertebrae on lateral radiographs could not represent the fracture-involved area and underestimated the total fracture-involved area. We suggested that the above 3 parameters could be easily obtained on CT sagittal reconstruction images, which might be better for assessing the potential instability of the thoracolumbar burst fracture and could become a valuable and indispensable examination for therapeutic decision making.

摘要

研究设计

影像学研究。

背景资料总结

X线和计算机断层扫描（CT）矢状面重建图像用于评估脊柱稳定性。然而，我们并不清楚它们之间的差异程度。

目的

本研究旨在比较胸腰椎爆裂骨折在侧位X线片和CT矢状面重建图像上的差异，并探讨其临床相关性。

材料与方法

采用45例胸腰椎爆裂骨折患者的侧位X线片和CT矢状面重建图像，记录以下测量值：侧位X线片上骨折椎体的压缩面积，以及CT矢状面重建图像上的矢状面压缩面积、骨碎片面积和骨折累及总面积。

结果

侧位X线片上骨折椎体压缩面积百分比为29.32±13.80%，CT矢状面重建图像上为27.93±12.21%；两者之间无显著差异（P>0.05）。CT矢状面重建图像上骨折累及总面积百分比为53.20±20.64%，高于侧位X线片（P<0.01）和CT矢状面重建图像（P<0.01）上测量的压缩面积。CT矢状面重建图像上骨碎片面积百分比为25.27±15.18%；骨碎片面积与压缩面积之间无显著相关性（r=0.1258，P>0.05）。