CAJ | 학술논문

目的探讨合并椎板骨折的L2-L5爆裂性骨折中硬脊膜撕裂及马尾神经卡压的创伤机制、发生率,以及哪些临床和影像学表现有助于术前判断硬脊膜撕裂和马尾神经卡压.方法对36例行手术治疗的合并椎板骨折的L2-L5爆裂性骨折进行回顾性分析.结果 36例中,16例(44.4%)并发硬脊膜撕裂,有硬脊膜撕裂的患者神经损伤程度明显重于无硬脊膜撕裂的患者,前者伤椎椎弓根间距增宽率明显高于后者.结论对于椎板骨折,尤其是裂缝骨折的患者,术前很难通过影像学表现明确判断是否有硬脊膜撕裂及马尾神经卡压.因此只要怀疑有硬脊膜撕裂,应首先选择后路手术方案,任何复位操作宜在椎管减压之后进行.
목적 탐토합병추판골절적L2-L5폭렬성골절중경척막시렬급마미신경잡압적창상궤제、발생솔,이급나사림상화영상학표현유조우술전판단경척막시렬화마미신경잡압.방법 대36례행수술치료적합병추판골절적L2-L5폭렬성골절진행회고성분석.결과 36례중,16례(44.4%)병발경척막시렬,유경척막시렬적환자신경손상정도명현중우무경척막시렬적환자,전자상추추궁근간거증관솔명현고우후자.결론 대우추판골절,우기시렬봉골절적환자,술전흔난통과영상학표현명학판단시부유경척막시렬급마미신경잡압.인차지요부의유경척막시렬,응수선선택후로수술방안,임하복위조작의재추관감압지후진행.
Objective To determine the incidence and mechanism of dural tears in burst frac-tures of the second through fifth lumbar vertebrae with lamina fractures and to find out if any spe-eific clinical and radiographic factors are predictive of dural tears and eauda equina entrapment. Methods 36 patients who had burst fractures of the second through fifh lumbar vertebrae with lamina fractures treated operatively were retrospectively reviewed. Results Dural tears were detect-ed in 16 (44.4%) of the 36 patients. There were a obviously association between a dural tear and neurologic deficit. Percentage increase of interpedicular distance was significantly higher(P<0.01 ) in cases with dural tears than that were in eases without dural tears. Conclusion It is difficult to detect dural tear and nerve root entrapment in greenstiek lamina fracture before surgery. Therefore, if there is any suspicion of such an occurrence,it should be the rule to begin with posterior ap-proach and use the open book technique to expose the dura safely before reduction maneuver.