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胸腰椎损伤：非手术治疗：适应证，治疗方法。

Thoracolumbar injuries: non operative treatment: indications, management.

机构信息

Department of Trauma and Orthopaedic Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.

University Hospital of Zürich, University of Zürich, Zürich, Switzerland.

出版信息

Eur J Trauma Emerg Surg. 2024 Oct;50(5):1951-1957. doi: 10.1007/s00068-024-02619-3. Epub 2024 Sep 27.

DOI:10.1007/s00068-024-02619-3
PMID:39331074
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11599295/
Abstract

INTRODUCTION: Thoracolumbar spine injuries can result from various traumatic events such as falls, motor vehicle accidents, and sports injuries. While surgical intervention is often indicated for complex fractures and in case of neurological deficits, non-operative treatment remains a viable option for certain types of injuries. AIMS: This manuscript aims to provide a comprehensive overview of the specific indications and treatment options of non-operative thoracolumbar spine injuries. It seeks to provide evidence-based recommendations for selecting patients suitable for conservative management based on fracture type and stability, absence of neurological deficits, spine deformity, integrity of the posterior ligament complex and patient specific factors.

摘要

简介：胸腰椎脊柱损伤可由多种创伤性事件引起，如跌倒、交通事故和运动损伤。虽然手术干预通常适用于复杂骨折和存在神经功能缺损的情况，但对于某些类型的损伤，非手术治疗仍然是一种可行的选择。

目的：本手稿旨在提供胸腰椎脊柱损伤非手术治疗的具体适应证和治疗方案的全面概述。它旨在根据骨折类型和稳定性、无神经功能缺损、脊柱畸形、后韧带复合体完整性以及患者特定因素，为选择适合保守管理的患者提供基于证据的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/4230eeb2618a/68_2024_2619_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/cab98c41f182/68_2024_2619_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/9ad1de539823/68_2024_2619_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/cb5f7b4e93ea/68_2024_2619_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/fd3dad61f232/68_2024_2619_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/c0b502d06926/68_2024_2619_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/dded37045a51/68_2024_2619_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/5aaeb8cbcde1/68_2024_2619_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/4230eeb2618a/68_2024_2619_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/cab98c41f182/68_2024_2619_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/9ad1de539823/68_2024_2619_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/cb5f7b4e93ea/68_2024_2619_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/fd3dad61f232/68_2024_2619_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/c0b502d06926/68_2024_2619_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/dded37045a51/68_2024_2619_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/5aaeb8cbcde1/68_2024_2619_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f3/11599295/4230eeb2618a/68_2024_2619_Fig8_HTML.jpg

相似文献

[1]
Thoracolumbar injuries: non operative treatment: indications, management.

Eur J Trauma Emerg Surg. 2024-10

[2]
Operative treatment of 733 patients with acute thoracolumbar spinal injuries: comprehensive results from the second, prospective, Internet-based multicenter study of the Spine Study Group of the German Association of Trauma Surgery.

Eur Spine J. 2010-5-25

[3]
[Operative treatment of traumatic fractures of the thoracic and lumbar spinal column: Part III: Follow up data].

Unfallchirurg. 2009-3

[4]
Management of thoracolumbar spine fractures.

Spine J. 2014-1

[5]
Thoracolumbar spine injuries.

Orthopedics. 1997-10

[6]
Thoracolumbar Spine Trauma.

Orthop Clin North Am. 2021-10

[7]
Surgical Practice in Traumatic Spinal Fracture Treatment with Regard to the Subaxial Cervical Injury Classification and Severity and the Thoracolumbar Injury Classification and Severity Systems: A Review of 58 Patients at the University of Wisconsin.

World Neurosurg. 2019-3-6

[8]
[Surgical treatment of injuries of the thoracolumbar transition. 2: Operation and roentgenologic findings].

Unfallchirurg. 2000-12

[9]
The surgical algorithm for the AOSpine thoracolumbar spine injury classification system.

Eur Spine J. 2016-4

[10]
Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Evaluation and Treatment of Patients with Thoracolumbar Spine Trauma: Executive Summary.

Neurosurgery. 2019-1-1

本文引用的文献

[1]
Retrospective Evaluation of Thoracolumbar Injury Classification System and Thoracolumbar AO Spine Injury Scores for the Decision Treatment of Thoracolumbar Traumatic Fractures in 458 Consecutive Patients.

World Neurosurg. 2021-9

[2]
"Outcome of thoracolumbar compression fractures following non-operative treatment".

Injury. 2021-12

[3]
Treatment of Fractures of the Thoracolumbar Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU).

Global Spine J. 2018-9

[4]
Vertebral body spread in thoracolumbar burst fractures can predict posterior construct failure.

Spine J. 2017-10-23

[5]
AOSpine Classification Systems (Subaxial, Thoracolumbar).

J Orthop Trauma. 2017-9

[6]
[Injuries of the thoracolumbar spine in children].

Orthopade. 2016-6

[7]
Nonoperative Management in Neurologically Intact Thoracolumbar Burst Fractures: Clinical and Radiographic Outcomes.

Spine (Phila Pa 1976). 2016-3

[8]
Relationships between posterior ligamentous complex injury and radiographic parameters in patients with thoracolumbar burst fractures.

Injury. 2015-2

[9]
Evidence-based management of traumatic thoracolumbar burst fractures: a systematic review of nonoperative management.

Neurosurg Focus. 2014

[10]
Outcome of traumatic intervertebral disk lesions after stabilization by internal fixator.

AJR Am J Roentgenol. 2014-7

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