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新的AO脊柱下颈椎损伤分类及其临床应用。

New AOSpine subaxial cervical spine injury classification and its clinical usage.

作者信息

Vaněk P

出版信息

Rozhl Chir. 2018 Spring;97(6):273-278.

Abstract

INTRODUCTION

The main aim of this paper is to introduce a new AOSpine subaxial cervical spine injury classification system to the national medical community since there is no generally accepted classification system until now.

METHOD

A description of the new AOSpine subaxial cervical spine injury classification and the basic principles of it exploitation are proposed in this text. Usage of the abovementioned classification in clinical practice is demonstrated on a sample of 48 patients who were investigated and treated at the author's department during the last two years. The assessment of injured spine stability and the surgical approach used are based on the above classification.

RESULTS

Type A0 injury was recorded in 5 (10.4%), A1 in 4 (8.3%), A2 in 2 (4.2%), A3 in 1(2.1%), A4 in 7 (14.6%), B2 in 2 (4.2%), B3 in 4 (8.3%), C in 12 (25%), F1 in 2 (4.2%), F2 in 4 (8.3%), F3 in 3 (6.3%) and F4 in 2 (4.2%) patients. Inter-observer agreement on each type of injury was achieved in 64.3%; as regards classification into the main groups A, B, C and D, consensus was reached in 89.3% cases. Eleven (22.9%) patients classified as A0, A1 and F1 were treated conservatively and 37 (77.1%) underwent surgery.

CONCLUSION

New AOSpine subaxial cervical spine injury classification represents a useful tool, allowing for proper assessment of injury severity and helping to select the type of eventual surgical procedure. Key words: classification - fracture - cervical spine - subaxial.

摘要

引言

本文的主要目的是向国内医学界介绍一种新的AO脊柱下颈椎损伤分类系统,因为目前尚无普遍接受的分类系统。

方法

本文介绍了新的AO脊柱下颈椎损伤分类及其开发的基本原则。在过去两年中,对作者所在科室接受检查和治疗的48例患者进行抽样,展示了上述分类在临床实践中的应用。基于上述分类对受伤脊柱稳定性进行评估并确定手术方式。

结果

记录到A0型损伤5例(10.4%),A1型4例(8.3%),A2型2例(4.2%),A3型1例(2.1%),A4型7例(14.6%),B2型2例(4.2%),B3型4例(8.3%),C型12例(25%),F1型2例(4.2%),F2型4例(8.3%),F3型3例(6.3%),F4型2例(4.2%)。观察者间对各损伤类型的一致性为64.3%;在分为主要组别A、B、C和D的分类方面,89.3%的病例达成了共识。11例(22.9%)分类为A0、A1和F1的患者接受了保守治疗,37例(77.1%)接受了手术。

结论

新的AO脊柱下颈椎损伤分类是一种有用的工具,有助于正确评估损伤严重程度并辅助选择最终手术方式的类型。关键词:分类 - 骨折 - 颈椎 - 下颈椎

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