合并椎板骨折的L2-L5爆裂性骨折伴硬膜及马尾神经卡压
张银顺;张建湘;华兴一;汤健;杨庆国;申才良;江曙;周剑
【期刊名称】《颈腰痛杂志》 【年(卷),期】2009(030)004
【摘要】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.%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. 【总页数】4页(313-316)
【关键词】爆裂性骨折;椎板骨折;硬脊膜撕裂;马尾神经 【作者】张银顺;张建湘;华兴一;汤健;杨庆国;申才良;江曙;周剑
【作者单位】安徽医科大学第一附属医院骨科三病区,安徽合肥,230022;安徽医科大学第一附属医院骨科三病区,安徽合肥,230022;安徽医科大学第一附属医院骨科三病区,安徽合肥,230022;安徽医科大学第一附属医院骨科三病区,安徽合肥,230022;安徽医科大学第一附属医院骨科三病区,安徽合肥,230022;安徽医科大学第一附属医院骨科三病区,安徽合肥,230022;安徽医科大学第一附属医院骨科三病区,安徽合肥,230022;安徽医科大学第一附属医院骨科三病区,安徽合肥,230022 【正文语种】中文 【中图分类】R683.2 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_journal-cervicodynia-lumbodynia_thesis/0201233370352.html 【相关文献】
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合并椎板骨折的L2-L5爆裂性骨折伴硬膜及马尾神经卡压
