【摘要】 目的　设计一种新的胸腰椎爆裂骨折分类方式———评分分级法来判断病情、指导临床治疗、评定治疗效果及估计预后。方法　选择病人的X线片及CT片显示的椎管狭窄、椎体压缩、后凸畸形及脊髓损伤平面以下感觉运动情况作为评分的指标进行分级。采用此方法对 10 9例胸腰椎爆裂骨折患者予以评分分级。Ⅰ级 (0～ 6分 ) 4 3例 ,采用非手术治疗 ;Ⅱ级 (7～ 11分 )4 7例 ,Ⅲ级 (12～ 16分 ) 19例 ,均分手术治疗组和非手术治疗组。结果　经治疗后 ,Ⅰ级患者神经损伤恢复有效率 90 % ;Ⅱ、Ⅲ级患者椎体前缘压缩高度由术前 4 9 5 %恢复到术后 94 % ,椎体后缘压缩高度由术前 84 %恢复到术后的 97 5 %。Ⅱ级患者手术组神经损伤恢复有效率 93% ,非手术组神经损伤恢复有效率 6 0 % ;Ⅲ级病人手术组神经损伤恢复有效率 6 0 % ,非手术组神经损伤恢复有效率 33%。结论　评分分级法对胸腰椎爆裂骨折患者病情严重程度的判定、治疗方式的选择、治疗效果的评定及预后估计具有指导意义更多还原

【Abstract】 Objective To design a new classification of thoracolumbar burst fracture for evaluating grade of injured condition,indicating clinic treatment,evaluating therapic effect and analysing prognosis.Methods X-ray appearance and CT scans,stenosis of spinal canal of roentgenograms,spinal kyphosis and alteration of sense and movement in spinal cord injury were taken as a standard.one hundred and nine cases of burst fracture in thoracolumbar spine were studied with evaluating grade.Forty three cases were grade Ⅰ(0～6) and non-operative reduction,47 cases gradeⅡ(7～11),and 19 cases grade Ⅲ(12～16) were divided into operative group and non-operative group.Results After treatment,nerve injury recovery efficiency was 90% in gradeⅠ.The heights of anterior and posterior vertebral body in postoperative rised from 49.4% and 84% to 94% and 97.5%.Stenosis of spinal canal obtained improvement obviously.Nerve injury recovery efficiency was 93% in the operative group in grade Ⅱ,60% in the non-operative group,60% in the operative group in grade Ⅲ,33% in the non-operative in grade Ⅲ.Conclusion The evaluating grades are to indicate significance for thoracolumbar burst fracture about severely degree of injuries,select operative type and analyse prognosis.更多还原