Gültekin Güliz D, Gülmen Vehbi, Arş Eda, Dilbaz Suna, Zileli Mehmet
Neurosurgery Department, İstanbul Medeniyet University Göztepe Education and Research Hospital, İstanbul, Turkey.
Neurosurgery Department, Gazi Hospital, Izmir, Turkey.
World Neurosurg. 2019 Apr;124:e25-e38. doi: 10.1016/j.wneu.2018.11.147. Epub 2018 Nov 28.
Transverse process fractures in trauma patients frequently are diagnosed using computed tomography and result in severe pain and limitation of motion. However, there is no accepted standard of care. Thus, these fractures can be treated with excessive measures or inadequately treated. In this study, diagnosis and treatment of transverse process fractures are examined.
The mechanisms of trauma, findings, and associated organ injuries of 50 patients with transverse process fractures and no other spinal injuries treated between 2013 and 2015 were recorded. The same treatment protocol was applied to each patient. The results of the treatments were examined retrospectively and recorded.
Deformation and edema of the fascia and muscles around the transverse process fractures were detected by computed tomography and magnetic resonance imaging. The average pain intensity of the patients before treatment was 8.8 of 10 on a visual analog scale and 5.2 of 10 after treatment with nonsteroidal anti-inflammatory drugs, muscle relaxants, flexible support corsets, and mobilization. Patients hospitalized for additional pathologies were primarily treated in thoracic surgery wards (11 of 15 patients). Transverse process fractures were caused by backward falls or blows to the back in 49 patients.
Transverse process fractures can be treated quickly and effectively with the recommended protocol after excluding any accompanying organ injuries or other spinal injuries. Transverse process fractures most often occur during backward falls or blows to the back, commonly low-energy injuries. This trauma mechanism can be described as a "coronal injury of the spine."
创伤患者的横突骨折通常采用计算机断层扫描进行诊断，会导致严重疼痛和活动受限。然而，目前尚无公认的治疗标准。因此，这些骨折可能会接受过度治疗或治疗不充分。在本研究中，对横突骨折的诊断和治疗进行了研究。
记录了2013年至2015年间接受治疗的50例无其他脊柱损伤的横突骨折患者的创伤机制、检查结果及相关器官损伤情况。对每位患者采用相同的治疗方案。对治疗结果进行回顾性检查并记录。
通过计算机断层扫描和磁共振成像检测到横突骨折周围筋膜和肌肉的变形及水肿。治疗前患者的平均疼痛强度在视觉模拟量表上为10分中的8.8分，在使用非甾体类抗炎药、肌肉松弛剂、柔性支撑束腰和活动后为10分中的5.2分。因其他病症住院的患者主要在胸外科病房接受治疗（15例患者中的11例）。49例患者的横突骨折是由向后摔倒或背部受击引起的。
在排除任何伴随的器官损伤或其他脊柱损伤后，采用推荐的方案可快速有效地治疗横突骨折。横突骨折最常发生在向后摔倒或背部受击时，通常为低能量损伤。这种创伤机制可描述为“脊柱的冠状损伤”。
