胸腰椎骨折:分类与稳定性。

IF 0.6
Steffen Warmann
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引用次数: 0

摘要

背景:胸腰椎骨折是最常见的脊柱损伤之一,与不稳定和神经功能障碍的高风险相关。准确的分类对于正确评估损伤的严重程度和开始正确的治疗至关重要。目的:介绍和分类目前的分类系统,特别是AO脊柱分类,对胸腰椎骨折进行结构化分析,考虑骨折形态、韧带稳定性和神经系统状态。方法:基于流行病学资料、生物力学原理和成像技术的文献评价。Denis, Magerl和AO脊柱分类的比较以及计算机断层扫描(CT)和磁共振成像(MRI)在诊断中的作用分析。结果:近年来胸腰椎骨折的发生率明显增加,尤其是老年患者。丹尼斯三支柱模型是评估稳定性的基础。AO脊柱分类提供了一个全面、实用的系统,该系统考虑了骨折形态(a - c型)、神经状态(N0-N4/NX)和患者特异性修饰因子(M1/M2)。CT是检测骨损伤的首选方法,而MRI在神经功能缺陷的情况下用于评估脊髓和韧带。结论:AO脊柱分类通过纳入相关临床参数,促进标准化交流,支持有充分根据的治疗决策。CT和MRI对于精确诊断是必不可少的。然而,对每个患者的个体评估,包括相关的合并症,仍然是选择最佳治疗和避免长期并发症的核心。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Thoracolumbar spine fractures : Classification and stability].

Background: Fractures of the thoracolumbar spine are among the most common spinal injuries and are associated with a high risk of instability and neurological deficits. Accurate classification is crucial to correctly assess the severity of injury and initiate the correct treatment.

Objectives: Presentation and classification of current classification systems, in particular the AO Spine classification, for the structured analysis of thoracolumbar spine fractures, taking into account fracture morphology, ligament stability, and neurological status.

Methods: Literature-based evaluation of epidemiological data, biomechanical principles and imaging techniques. Comparison of the Denis, Magerl, and AO Spine classifications and analysis of the role of computed tomography (CT) and magnetic resonance imaging (MRI) in diagnosis.

Results: The incidence of thoracolumbar fractures has increased significantly in recent years, especially in older patients. The Denis three-pillar model serves as a basis for assessing stability. The AO Spine classification offers a comprehensive, practical system that takes into account fracture morphology (type A-C), neurological status (N0-N4/NX), and patient-specific modifiers (M1/M2). CT is the method of choice for the detection of bony injuries, while MRI is indicated for the assessment of the spinal cord and ligaments in cases of neurological deficits.

Conclusion: The AO Spine classification facilitates standardized communication and supports well-founded treatment decisions by incorporating relevant clinical parameters. CT and MRI are indispensable for precise diagnosis. Nevertheless, the individual assessment of each patient, including relevant comorbidities, remains central to choosing optimal treatment and avoiding long-term complications.

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