Zhang Zhenhui, Pan Qiangqiang, Wang Qingde, Mei Wei, Chen Xuyi
Medical College of Tianjin University, Tianjin, 300072, China.
Department of Spinal Surgery, Zhengzhou Orthopaedics Hospital, Zhengzhou, 450052, Henan province, China.
BMC Musculoskelet Disord. 2025 Jan 7;26(1):26. doi: 10.1186/s12891-024-08269-1.
Lumbar burst fracture combined with lamina fracture is a special type of spinal fracture. Neither CT nor MRI can accurately determine it. The present study aims to investigate the clinical value of 3D CT/MRI fusion imaging in the treatment of lumbar burst fracture complicated with lamina fracture.
The clinical data of 38 patients with lumbar burst fracture combined with lamina fracture admitted to our hospital from January 2015 to December 2020 were retrospectively analyzed. CT and MRI examinations were performed before surgery, and the 3D fusion images of CT and MRI were reconstructed by Medraw software to determine whether lumbar burst fractures with interlaminar herniation of the cauda equine and entrapped nerve root. The American Spinal Injury Association (ASIA) scale was used to evaluate neurological function before and after surgery.
All patients underwent posterior lumbar decompression and fusion. Among them, 30 (78.9%) patients had a dural hernia of the cauda equina. The follow-up time was (17.8 ± 1.6) months, the average operative time was 115.6 min (85-162 min), and the mean blood loss was 185.3 mL (136-240 mL). At the last follow-up, ASIA scale of neurological function was as follows: 5 cases were grade C, eight were grade D, and twenty-five were grade E. The difference was statistically significant compared with that before the operation (P < 0.05). Delayed wound healing occurred in 2 patients after surgery, and they were cured after systematic treatment.
The 3D CT/MRI fusion imaging can accurately and intuitively construct the position relationship of the dura mater, cauda equina and the posterior fractured lamina, which can guide the formulation of a surgical plan and determine the range of nerve decompression.
Not applicable.
腰椎爆裂骨折合并椎板骨折是一种特殊类型的脊柱骨折。CT和MRI均无法准确判定该骨折情况。本研究旨在探讨三维CT/MRI融合成像在腰椎爆裂骨折合并椎板骨折治疗中的临床价值。
回顾性分析2015年1月至2020年12月我院收治的38例腰椎爆裂骨折合并椎板骨折患者的临床资料。术前进行CT和MRI检查，采用Medraw软件重建CT与MRI的三维融合图像，以判定是否存在马尾神经层间疝及神经根受压的腰椎爆裂骨折。采用美国脊髓损伤协会（ASIA）评分标准评估手术前后神经功能。
所有患者均接受了后路腰椎减压融合术。其中，30例（78.9%）患者存在马尾神经硬膜疝。随访时间为（17.8±1.6）个月，平均手术时间为115.6分钟（85 - 162分钟），平均失血量为185.3毫升（136 - 240毫升）。末次随访时，神经功能ASIA评分为：C级5例，D级8例，E级25例。与术前相比差异有统计学意义（P < 0.05）。术后2例患者出现伤口延迟愈合，经系统治疗后治愈。
三维CT/MRI融合成像能够准确、直观地构建硬脑膜、马尾神经与骨折后椎板的位置关系，可指导手术方案的制定并确定神经减压范围。
不适用。
