Yunoki M, Suzuki K, Uneda A, Yoshino K
Department of Orthopaedics, Kagawa Rosai Hospital, Marugame City, Japan.
Malays Orthop J. 2016 Mar;10(1):11-15. doi: 10.5704/MOJ.1603.003.
Patients with traumatic intracranial hemorrhage (ICH) or skull fracture are typically admitted to the Department of Neurosurgery for fear of delayed neurological deterioration. Neurosurgeons, therefore, must be careful not to overlook a spinal fracture in these patients. In this study, we investigated the occurrence and risk factor of spinal fracture in patients with traumatic ICH or skull fracture. We retrospectively analyzed the hospital records of 134 patients admitted to the Department of Neurosurgery at Kagawa Rosai Hospital for traumatic ICH or skull fracture. The etiology of trauma, level of consciousness, presence or absence of ICH, skull fracture, craniotomy and spinal surgery were investigated. Furthermore, in cases of spinal fracture, its type, neurological symptoms, treatment were investigated. In an analysis of 134 patients, Ground level fall and traffic accident were the most frequent etiologies of trauma (47.0% and 23.9% respectively). Glasgow coma scale on admission was 15-13 for 106 patients (79.1%). spinal fracture was identified in 10 of 134 patients (7.5%). Two patients had cervical, 8 had thoracolumbar fractures. In the analysis of risk factors, an accidental fall and skull fracture was observed significantly more in the spinal fracture cases. The majority of traumatic ICH or skull fracture cases treated in the Department of Neurosurgery were caused by minor head impacts. When treating these patients, it is necessary to investigate not only the cervical, but also the thoracolumbar spine, especially when the cause of injury is an accidental fall and a skull fracture is identified.
创伤性颅内出血（ICH）或颅骨骨折患者通常因担心出现延迟性神经功能恶化而被收入神经外科。因此，神经外科医生必须小心，不要忽视这些患者的脊柱骨折。在本研究中，我们调查了创伤性ICH或颅骨骨折患者脊柱骨折的发生率及危险因素。我们回顾性分析了香川罗西医院神经外科收治的134例创伤性ICH或颅骨骨折患者的医院记录。调查了创伤的病因、意识水平、ICH的有无、颅骨骨折、开颅手术及脊柱手术情况。此外，对于脊柱骨折病例，还调查了其类型、神经症状及治疗情况。在对134例患者的分析中，平地跌倒和交通事故是最常见的创伤病因（分别为47.0%和23.9%）。106例患者（79.1%）入院时格拉斯哥昏迷量表评分为15 - 13分。134例患者中有10例（7.5%）被确诊为脊柱骨折。2例为颈椎骨折，8例为胸腰椎骨折。在危险因素分析中，脊柱骨折病例中意外跌倒和颅骨骨折的发生率明显更高。神经外科治疗的大多数创伤性ICH或颅骨骨折病例是由轻微头部撞击引起的。在治疗这些患者时，不仅要检查颈椎，还需检查胸腰椎，尤其是当损伤原因是意外跌倒且存在颅骨骨折时。
