Louis R
Nouv Presse Med. 1979 May 26;8(23):1931-7.
Clinical and radiologic investigations in spinal fractures and dislocations must allow assessment of modifications in osteoarticular and neural functions. With respect to osteoarticular function it is necessary to identify the presence of both temporary or permanent instability and impaired static equilibrium. Regarding neural functions we must not only evaluate the neurologic damage but also residual stenosis of the spinal canal and sometimes of the intervertebral foramina. Compression induced by such stenosis is best demonstrated on métrizanide myelography. Management is currently aimed at better and more rapid correction of morphologic damages and disturbed stability. These goals are achieved by reduction and stabilisation using orthopedic or surgical techniques, the later involving an anterior or posterior approach to osteosynthesis. Systematic suppression of factors causing neural compression has led to a greater recovery rate than in the past.
对脊柱骨折和脱位进行临床及放射学检查时,必须能够评估骨关节和神经功能的改变。就骨关节功能而言,有必要确定是否存在暂时或永久性不稳定以及静态平衡受损。关于神经功能,我们不仅要评估神经损伤,还要评估椎管以及有时椎间孔的残余狭窄情况。这种狭窄引起的压迫在美曲膦酯脊髓造影上显示最佳。目前的治疗旨在更好、更快速地纠正形态学损伤和稳定性紊乱。这些目标通过采用矫形或手术技术进行复位和固定来实现,后者包括前路或后路骨合成入路。系统性消除引起神经压迫的因素已使恢复率高于过去。