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强直性胸椎的伸展型骨折伴严重移位导致食管破裂。

Extension type fracture of the ankylotic thoracic spine with gross displacement causing esophageal rupture.

作者信息

Groen F R J, Delawi D, Kruyt M C, Oner F C

机构信息

University Medical Center Utrecht, Heidelberglaan 100, Huispostnummer G 05.228, 3584 CX, Utrecht, The Netherlands.

出版信息

Eur Spine J. 2016 May;25 Suppl 1:183-7. doi: 10.1007/s00586-015-4315-1. Epub 2015 Nov 11.

Abstract

PURPOSE

This study aimed at discussing the relevance of the type B3 fracture of the new AOSpine classification.

METHODS

Hyperextension fractures of the spine are rare in the general population, but common in the ankylotic spine. We present a case of a severe spinal fracture with concomitant esophageal rupture, which was diagnosed early and could be treated during the initial trauma care.

RESULTS

The spinal column was stabilized using a percutaneous technique after which the perforated esophagus was sutured through a thoracotomy. The spinal injury was classified a type B3 fracture using the new AOSpine classification.

CONCLUSION

The B3 typification raised a lot of discussion during the development of the new classification system and may be controversial. This case, however, nicely illustrates the relevance of an intact posterior hinge as compared to C-type injuries where complete dissociation is present with inherent spinal cord damage.

摘要

目的

本研究旨在探讨新的AO脊柱分类中B3型骨折的相关性。

方法

脊柱过伸性骨折在普通人群中较为罕见,但在强直性脊柱炎患者中较为常见。我们报告一例严重脊柱骨折合并食管破裂的病例,该病例早期诊断明确,并在初始创伤救治期间得到治疗。

结果

采用经皮技术稳定脊柱,随后通过开胸手术缝合穿孔的食管。根据新的AO脊柱分类,该脊柱损伤被归类为B3型骨折。

结论

在新分类系统的制定过程中,B3型分类引发了诸多讨论,可能存在争议。然而,该病例很好地说明了完整后方铰链的相关性,与存在完全分离且伴有固有脊髓损伤的C型损伤形成对比。

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