Aso-Escario José, Sebastián Cristina, Aso-Vizán Alberto, Martínez-Quiñones José Vicente, Consolini Fabián, Arregui Ricardo
Department of Neurosurgery. Hospital MAZ, Zaragoza.
Department of Radiology, Hospital MAZ, Zaragoza.
Orthop Rev (Pavia). 2019 May 23;11(2):7774. doi: 10.4081/or.2019.7774.
The time interval between the date of trauma and the diagnosis of vertebral column fractures hinders management and increases liability. We have examined the features and implications of this delay. 585 consecutive thoracolumbar fractures (2005-2016), were considered; 382 (65.30%) were males and 203 (34.70%) females. Mean age was 51 yr. Fall from a height (187; 31.97%), simple fall (147; 25.13%) and road accidents (111; 18.97%) were the most frequent causes of trauma. Physical exertion caused 8.38% (N=49). 142 patients (24.27%) were not diagnosed on the injury day (mean = 3.2 days). Delay was longer in females (mean = 5.5 . 2.7 days) and shorter in falls from a height (mean = 2.3) or road accidents (2.8). Mean age of diagnosed on the injury day differed from those diagnosed in the first month (49.2 60.1). Plain X-ray signs were found in 7 misdiagnosed cases (46.6%). Delay was more frequent in low mineralization cases. Diagnostic delay of spine fractures is frequent. Some risk profiles can help to reduce it. Careful emergency X-ray examination is encouraged, as well as early magnetic resonance imaging in risk profiles.
创伤日期与脊柱骨折诊断之间的时间间隔会妨碍治疗并增加责任风险。我们研究了这种延迟的特征及影响。纳入了585例连续的胸腰椎骨折患者（2005 - 2016年）；其中男性382例（65.30%），女性203例（34.70%）。平均年龄为51岁。高处坠落（187例；31.97%）、单纯跌倒（147例；25.13%）和道路交通事故（111例；18.97%）是最常见的创伤原因。体力活动导致的占8.38%（n = 49）。142例患者（24.27%）在受伤当天未被诊断出来（平均延迟3.2天）。女性的延迟时间更长（平均 = 5.5±2.7天），而高处坠落（平均 = 2.3天）或道路交通事故（2.8天）后的延迟时间较短。受伤当天确诊的患者平均年龄与第一个月确诊的患者不同（49.2对60.1）。7例误诊病例（46.6%）中发现了X线平片征象。低骨矿化病例中延迟更常见。脊柱骨折的诊断延迟很常见。一些风险特征有助于减少延迟。鼓励进行仔细的急诊X线检查，以及对具有风险特征的患者尽早进行磁共振成像检查。
