Li Yao, Huang Mingyu, Xiang Jie, Lin Yan, Wu Yaosen, Wang Xiangyang
Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, China.
Department of Orthopaedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
World Neurosurg. 2018 Oct;118:e72-e78. doi: 10.1016/j.wneu.2018.06.122. Epub 2018 Jun 23.
To correlate interpedicular distance (IPD) with radiographic parameters, neurologic deficit, and posterior structures injury in patients with thoracolumbar burst fractures.
A total of 103 patients with a thoracolumbar burst fracture retrospectively reviewed. IPD was measured from the medial sclerotic areas of the pedicles on anteroposterior plain radiographs. Data on local kyphosis (LK), the ratio of anterior to posterior vertebral height (A/P ratio), loss of vertebral body height (LOVBH), spinal canal stenosis (SCS), neurologic status, and injuries to posterior structures (lamina, posterior ligamentous complex, and facet joint) were correlated with IPD using correlation analysis. Logistic regression analysis was used to determine the threshold of IPD predictive of neurologic deficit and posterior structure injury.
Of the 103 patients, 98 (95.15%) presented with increased IPD, ranging from 1.41% to 41.53% (mean, 10.92 ± 3.37%). Regarding radiographic parameters, both LK and SCS were linearly correlated with IPD. There was a significant correlation between IPD and neurologic status; logistic regression analysis identified an IPD increase of >20% as an indicator of neurologic deficit. In addition, both facet joint injury and lamina fracture were associated with IPD, with an IPD increase >15% as an indicator of facet joint injury and an IPD increase >20% a predictor of lamina fracture.
Our results indicate that IPD is correlated with LK, SCS, neurologic status, facet joint injury, and lamina fracture. Our data demonstrate that IPD measured from plain radiographs is a reliable indicator for assessment of thoracolumbar burst fractures.
探讨胸腰椎爆裂骨折患者的椎弓根间距（IPD）与影像学参数、神经功能缺损及后部结构损伤之间的相关性。
回顾性分析103例胸腰椎爆裂骨折患者。在前后位X线平片上，从椎弓根内侧硬化区测量IPD。采用相关性分析，将局部后凸（LK）、椎体前后高度比（A/P比）、椎体高度丢失（LOVBH）、椎管狭窄（SCS）、神经功能状态以及后部结构（椎板、后韧带复合体和小关节）损伤等数据与IPD进行相关性分析。采用逻辑回归分析确定预测神经功能缺损和后部结构损伤的IPD阈值。
103例患者中，98例（95.15%）IPD增大，增幅为1.41%至41.53%（平均10.92±3.37%）。在影像学参数方面，LK和SCS均与IPD呈线性相关。IPD与神经功能状态之间存在显著相关性；逻辑回归分析确定IPD增幅>20%为神经功能缺损的指标。此外，小关节损伤和椎板骨折均与IPD相关，IPD增幅>15%为小关节损伤的指标，IPD增幅>20%为椎板骨折的预测指标。
我们的结果表明，IPD与LK、SCS、神经功能状态、小关节损伤和椎板骨折相关。我们的数据表明，通过X线平片测量的IPD是评估胸腰椎爆裂骨折的可靠指标。
