【摘要】 目的　探讨胸腰椎爆裂性骨折椎管形态改变与脊髓损伤的关系。方法　对 5 6例胸腰椎爆裂性骨折病人进行CT、X线检查 ,测量椎管矢状径、横径、椎管面积和Cobb角 ,计算椎管狭窄率、椎管侵占率及矢状径与横径之比 ,并对病人的神经功能状况进行评估。结果　脊髓损伤组与无脊髓损伤组的椎管狭窄率、椎管侵占率、Cobb角、矢状径与横径之比的差异无显著性(P >0 0 5 ) ;31例脊髓损伤病人低运动评分组 (<2 5分 )与高运动评分组 (≥ 2 5分 )的椎管狭窄率、椎管侵占率和Cobb角的差异有显著性 (P <0 0 5 ) ,椎管狭窄率、椎管侵占率与ASIA损伤分级和运动评分呈负相关 (rs=- 0 4 6～ - 0 5 2 ,P≤0 0 1) ,Cobb角与ASIA损伤分级呈负相关 (rs=- 0 36 ,P <0 0 5 )。结论　椎管静态侵占和后凸畸形对胸腰椎爆裂性骨折的脊髓损伤结果有影响。更多还原

【Abstract】 Objective To determine the relationship between morphological change of the spinal canal in thoracolumbar burst fracture and spinal cord injury (SCI).Methods Fifty-six patients with thoracolumbar burst fracture were included.Computed tomographic scans and plain roentgenograms were used to measure the sagittal and transverse diameters, the Cobb angle and the surface area of the spinal canal. The percentage of spinal canal stenosis and spinal canal impingement, and the ratio of sagittal-to-transverse diameter were calculated. The neurological status was evaluated.Results No differences were found in the percentage of spinal canal stenosis and spinal canal impingement, the Cobb angels and the ratios of sagittal-to-transverse diameter between the patients with and without SCI (P>0.05). However, the percentage of spinal canal stenosis and spinal canal impingement and the Cobb angel were significantly higher in the SCI patients with lower motor scores (<25 points) than with higher motor scores (≥25 points) (P<0.05). The percentages of spinal canal stenosis and spinal canal impingement showed a negative correlation with both ASIA impairment and motor index score (r s=-0.46～-0.52,P≤0.01), and the Cobb angel showed a negative correlation with ASIA impairment either (r s=-0.36,P<0.05).Conclusion The static canal encroachment and the kyphosis in thoracolumbar burst fracture affect the severity of SCI.更多还原