胸肋复合体损伤对胸椎骨折稳定性影响的初步临床研究.pdfVIP

The operated patients with Cob angle of thoracic fractures ≥20° were accounted for 47.5% and 57.9% respectively, ones with cross-sectional area of intraspinal bone fragments≥ 1/3 cross-sectional area of the spinal canal were accounted for 55.0% and 68.4% respectively, and ones with reduction of more than 50% of the sagittal area of the fractured vertebral body were accounted for 42.5% and 52.6% respectively in these two groups, which resulted in poor stability. In T+BR group and T+BRS group the average TLICS score were 5.0 ± 2.0 points and 5.3 ± 1.8 points respectively, significantly higher than the 3.5 ± 1.9 points in T group and 3.8 ± 2.0 points in T +OR group (p 0.05 ), which indicated that thoracic vertebral fracture injury was more severe and the poor stability in the former groups. The operated patients with 4 points in the TLICS score, The cure rate of T+BRS group was 75.0% ,which was higher than 8.3% in T group （p ＜0.0 1）. There usually was a posterior long segmental fixation in T+BR group and T+BRS group. The rate of postoperative complications in the T+BRS group was 46.7%, which was obviously higher than T group （p ＜0.01）. There was statistical difference between T+BRS group and T group in Frankel scores before and after the operation （p ＜0.05 ）. Conclusion: 1、Sternocostal complex injure can influence the stability of the thoracic vertebral fractures, 2 、It is necessary to take the rib and sternum injure into consideration for the evaluation of thoracic vertebral fractures with TLICS score . Key words: thoracic fractures; rib fracture; Sternum fracture; stability 4 前 言 胸椎骨折是脊柱损伤中最常见的疾病之一，以往在对胸椎骨折进行分类时， 由于其解剖结构、受伤机制、损伤形态等诸多方面与腰椎骨折存在一定共性，因 而对胸腰椎骨折通常采取统一的分类方法。最早的胸腰椎骨折分类是由Boehle