Glass R B, Sivit C J, Sturm P F, Bulas D I, Eichelberger M R
Department of Diagnostic Imaging and Radiology and Pediatrics, Children's National Medical Center, Washington, DC.
J Trauma. 1994 Nov;37(5):815-9.
Thirty-five children with lumbar spine injuries were evaluated with computed tomography and plain radiography following blunt trauma. The majority of these children (31) were injured in motor vehicle crashes; most of them (27 of 35, 77%) were restrained by lap-styled safety belts. The other mechanisms of injury included motor vehicle crashes involving a pedestrian (2), a fall (1), and a crush (1). The types of injuries encountered were subluxation or distraction combined with fracture in 18; fracture only in 13; and distraction only in four. Abnormalities were not detected with thick-section computed tomographic (CT) scans in 20 (57%) of the cases. Children involved in motor vehicle crashes are at high risk for lumbar spine injuries, because the sudden deceleration forces may cause hyperflexion, resulting in vertebral body compression or interspinous ligament disruption. Lumbar spine radiographs are necessary in all cases with suspected lumbar spine injury because the abnormality may be missed by thick-section CT scanning and may not be detected even with complementary thin sections.
对35名腰椎损伤儿童在钝性创伤后进行了计算机断层扫描和X线平片评估。这些儿童中的大多数（31名）在机动车碰撞事故中受伤；其中大多数（35名中的27名，77%）系着腰部安全带。其他损伤机制包括涉及行人的机动车碰撞事故（2例）、跌倒（1例）和挤压伤（1例）。所遇到的损伤类型为半脱位或牵张合并骨折18例；单纯骨折13例；单纯牵张4例。20例（57%）病例的厚层计算机断层扫描（CT）未检测到异常。涉及机动车碰撞事故的儿童腰椎损伤风险很高，因为突然的减速力可能导致脊柱过度前屈，从而导致椎体压缩或棘间韧带断裂。所有疑似腰椎损伤的病例都需要进行腰椎X线平片检查，因为厚层CT扫描可能会漏诊异常，即使使用补充薄层扫描也可能检测不到。
