Kyphotic Angle of the Motion Segment Most Accurately Predicts Injury to the Ligamentous Complex on Computed Tomography Scan of Thoracolumbar Fractures
Kyphotic Angle of the Motion Segment Most Accurately Predicts Injury to the Ligamentous Complex on Computed Tomography Scan of Thoracolumbar Fractures
复制标题
运动节段的后凸角最准确地预测胸腰椎骨折计算机断层扫描中韧带复合体的损伤
DOI：
10.1016/j.wneu.2018.06.202
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发表时间：
2018-10-01
影响因子：
2
通讯作者：
Wu, Qionghua
中科院分区：
文献类型：
--
作者：
Jiang, Lifeng;Zhang, Hua;Wu, Qionghua
目的：目的：探讨经MRI检查证实的胸腰椎（TL）骨折患者后韧带复合体（PLC）损伤的影像学参数和CT诊断的准确性。方法：我们回顾性分析了88例TL骨折患者，根据MRI显示的PLC状态分为2组：完整组和破裂组。评估的参数包括前部骨折椎体高度（AVH）和后部骨折椎体高度、上部和下部AVH、前后椎体高度比、AVH比、局部后凸角（LKA）、区域角（RA）、矢状指数（SI）、Gardner角（GA）、Gardner指数（GI）、Cobb角、棘突间距离（ISD）、上部和下部ISD、ISD比、棘突间负距离（ISDM）、棘突间角（伊萨）和上下伊萨。结果：原发性肝癌破裂与RA、GA、GI、ISD、ISD比值、ISDM相关。PLC破裂的阳性危险因素为GA、LKA、SI和RA。PLC破裂的阴性危险因素是SI> 20度和GI。在A1/A2型骨折患者中，PLC破裂与SI、上棘突间距离、ISD比率、ISDM和伊萨相关，在A3/A4型骨折患者中，PLC破裂与GA、GI、ISD、ISD比率和ISDM相关。RA大于16度，SI大于20度，GI大于24度与A型TL骨折患者的PLC损伤相关，A1型和A2型骨折中，RA> 16度和SI> 20度预测PLC损伤。在A3和A4型骨折中，SI大于20度、GI大于24度、LKA大于26度和ISD比率大于56%预测PLC损伤。
OBJECTIVE: To define radiologic parameters and the diagnostic accuracy of computed tomography (CT) scan on posterior ligamentous complex (PLC) injury, identified by magnetic resonance imaging (MRI) in patients with thoracolumbar (TL) fracture.METHODS: We retrospectively analyzed 88 patients with TL fractures divided into 2 groups by PLC status evident on MRI: intact and ruptured. The parameters assessed included the anterior fractured vertebral body height (AVH) and posterior fractured vertebral body height, upper and lower AVH, anterior/posterior vertebral height ratio, AVH ratio, local kyphotic angle (LKA), region angle (RA), sagittal index (SI), Gardner angle (GA), Gardner index (GI), Cobb angle, interspinous distance (ISD), upper and lower ISD, ISD ratio, interspinous distance minus (ISDM), interspinous angle (ISA), and upper and lower ISA. The t test, Pearson chi(2) test, and multivariate logistic regression were used.RESULTS: PLC rupture (vs. intact) was associated with RA, GA, GI, ISD, ISD ratio, and ISDM. The positive risk factors for PLC rupture were GA, LKA, SI, and RA. The negative risk factors for PLC rupture were SI greater than 20 degrees and GI. PLC rupture was associated with the SI, upper interspinous distance, ISD ratio, ISDM, and ISA in those with type A1/A2 fractures and the GA, GI, ISD, ISD ratio, and ISDM in those with type A3/A4 fractures.CONCLUSIONS: An RA greater than 16 degrees, SI greater than 20 degrees, and GI greater than 24 degrees were associated with PLC injury in patients with type A TL fractures, and an RA greater than 16 degrees and SI greater than 20 degrees predicted PLC injury in type A1 and A2 fractures. An SI greater than 20 degrees, GI greater than 24 degrees, LKA greater than 26 degrees, and ISD ratio greater than 56% predicted PLC injury in type A3 and A4 fractures.