CAJ | 학술논문

目的分析脊柱骨折的流行病学特点,以提高脊柱骨折的预防及救治水平.方法总结2001年5月-2011年5月收治的1393例脊柱骨折患者资料,其中男955例,女438例;年龄4～89岁,平均45.5岁,并进行流行病学统计分析.结果 1393例患者中年龄分布主要集中在30～49岁,占49.7％(692/1393).59岁以下5个年龄组段男性人数均较女性多,而60岁以上2个年龄组段则呈现女性损伤人数多于男性的趋势.高处坠落伤、交通伤是主要致伤原因,占59.4％(827/1393).1963个损伤节段中颈椎、胸椎、腰椎及骶尾椎损伤所占比例依次为23.8％(468/1963)、31.9％(627/1963)、43.9％(861/1963)、0.4％(7/1963).脊柱骨折多发部位为胸腰段(T10～L2),占55.4％(1087/1963),其中L1、T12、L2分别占22.5％(441/1963)、5.4％(303/1963)、11.1％(218/1963).颈椎多发骨折部位为C2、C5、C6,分别占6.4％(123/1 963)、5.3％(105/1963)和4.0％(78/1963).在多节段骨折患者中,高处坠落伤与交通伤分别占35.9％(78/217)和17.1％(37/217).合并伤患者中,高处坠落伤与交通伤分别占48.1％(176/366)和25.1％(92/366).美国脊髓损伤协会(ASIA)分级主要以E、D、A级为主,分别占52.6％(733/1393)、21.0％(293/1 393)和15.3％(213/1393).其中1038例患者进行手术治疗,术前脊髓功能分级主要以E、D、A级为主,分别占48.0％(498/1038)、22.2％(231/1038)和17.1％(177/1038),术后3周E级患者占56.6％(588/1038).结论从脊柱骨折的流行病学特点可以看出,高处坠落伤及交通伤是主要致伤因素,同时易引起脊柱多节段骨折和全身合并伤,应根据其特点进行防治.
목적 분석척주골절적류행병학특점,이제고척주골절적예방급구치수평.방법 총결2001년5월-2011년5월수치적1393례척주골절환자자료,기중남955례,녀438례;년령4～89세,평균45.5세,병진행류행병학통계분석.결과 1393례환자중년령분포주요집중재30～49세,점49.7％(692/1393).59세이하5개년령조단남성인수균교녀성다,이60세이상2개년령조단칙정현녀성손상인수다우남성적추세.고처추락상、교통상시주요치상원인,점59.4％(827/1393).1963개손상절단중경추、흉추、요추급저미추손상소점비례의차위23.8％(468/1963)、31.9％(627/1963)、43.9％(861/1963)、0.4％(7/1963).척주골절다발부위위흉요단(T10～L2),점55.4％(1087/1963),기중L1、T12、L2분별점22.5％(441/1963)、5.4％(303/1963)、11.1％(218/1963).경추다발골절부위위C2、C5、C6,분별점6.4％(123/1 963)、5.3％(105/1963)화4.0％(78/1963).재다절단골절환자중,고처추락상여교통상분별점35.9％(78/217)화17.1％(37/217).합병상환자중,고처추락상여교통상분별점48.1％(176/366)화25.1％(92/366).미국척수손상협회(ASIA)분급주요이E、D、A급위주,분별점52.6％(733/1393)、21.0％(293/1 393)화15.3％(213/1393).기중1038례환자진행수술치료,술전척수공능분급주요이E、D、A급위주,분별점48.0％(498/1038)、22.2％(231/1038)화17.1％(177/1038),술후3주E급환자점56.6％(588/1038).결론 종척주골절적류행병학특점가이간출,고처추락상급교통상시주요치상인소,동시역인기척주다절단골절화전신합병상,응근거기특점진행방치.
Objective To analyze the epidemiologic features of traumatic spinal fracture so as to improve its prevention and treatment levels.Methods A total of 1393 patients with spinal fractures(955 males,438 females,at age range of 4-89 years,mean 45.5 years)treated between May 2001 and May 2011 were reviewed to statistically analyze their epidemiologic characteristics.Results The age of all the patients was mainly focused at 30-49 years,accounting for 49.7％(692/1393).Males exceeded females in number among the five age groups below 59 years old,but the opposite tendency appeared in the two age groups above 60 years old.Fall from height and traffic accidents were the main injury causes,which accounted for 59.4％(827/1393).Among 1963 injury segments,cervical vertebral injury,thoracic vertebral injury,lumbar vertebral injury,sacrum and coccyx injury accounted for 23.8％(468/1963),31.9％(627/1963),43.9％(861/1963)and 0.4％(7/1963)respectively.Spinal fractures occurred largely in thoracolumbar segment(T10-L2),which accounted for 55.4％(1087/1963),and L1,T12 and L2 occupied 22.5％(441/1963),5.4％(303/1963),11.1％(218/1963)respectively.The predilection sites of fractures in cervical vertebrae were C2(6.4％,123/1963),C5(5.3％,105/1963)and C6(4.0％,78/1963)respectively.Of the patients with multiple level spinal fractures,the injury resulted from fall from height and traffic accidents accounted for 35.9 ％(78/217)and 17.1％(37/217)respectively.Of the patients with combined injury,the injury caused by fall from height and traffic accidents occupied 48.1％(176/366)and 25.1％(92/366)respectively.According to the American Spinal Injury Association(ASIA)scale,the injury degree of all the patients was mainly grade E(52.6％,733/1393),D(21.0％,293/1393)and A(15.3％,213/1393).A total of 1038 patients had surgical treatment.Their spinal function was mainly graded as level E(48.0％,498/1038),D(22.2％,231/1038)and A(17.1％,177/1038)pre-operatively,but the rates of patients with level E spinal function increased to 56.6％(588/1038)three weeks post-operatively.Conclusions The epidemiologic survey reveals that fall from height and traffic accidents are the main factors for spinal fractures and can easily lead to multi-level spinal fractures and systematic complications.Thereby,prevention and treatment methods should be designed according to the injury characteristics.