SPINAL INJURIES OF THORACOLUMBAR SPINE

胸腰椎脊髓损伤

• 批准号: 3159186
• 负责人: MANOHAR M PANJABI
• 金额: $ 21.75万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-12-01 至 1994-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3159186
• 关键词: biomechanics; cinematography; computed axial tomography; disease /disorder classification; fracture fixation; health care cost /financing; human tissue; musculoskeletal disorder diagnosis; patient care management; radiography; safety equipment; spinal disk injury; trauma

Fractures of the thoracolumbar region of the spine are serious disabling injuries resulting in personal suffering and significant loss to society. These result from many causes, such as high speed auto accidents, falls, blows, sports and ejection of airplane pilots at high speed. There is high risk associated with these injuries because of certain anatomic relationships. The junction of the conus medularis and cauda equina is adjacent to the thoracolumbar junction, the most common site of spinal injury. Further, this junction between the relatively rigid rib cage and the more flexible lumbar spine creates a potential for second injury during the time of transport to and treatment in the hospital. The treatment of these injuries depends to a large degree on the determination of the stability/instability status of the spine. Although there are several clinical guidelines, the decision is often based on subjective judgement. There are no objective experimental studies to help the physician make this important decision. The primary goal of our proposal is to develop such objective guidelines by producing clinically relevant spinal injuries, objectively evaluating their spinal instability, and then correlating one with the other. Fractures and dislocations will be produced dynamically in fresh thoracolumbar spine specimens to simulate clinical situations. Loads, displacements and deformations will be recorded during trauma, using computers and high speed movie cameras. X-rays and CT-scans before and after trauma will be taken. Multi-directional instability will be measured before and after trauma. The injured specimen will be studied morphologically, and its image will be reconstructed using computer graphics for three-dimensional visualization of the fractures. The data will be analyzed to determine relationships between various types of parameters, but especially between the roentgenographic images (x-rays and CT-scans) and the multi-directional spinal instability of the injured specimens. Clinical relevance is one of the primary aims of this study and it may participate in health care cost containment at the level of diagnosis and treatment.

脊柱胸腰段骨折是严重的致残性疾病 造成个人痛苦和重大社会损失的伤害。 这些都是由许多原因造成的，如高速车祸，福尔斯， 飞行员在高速飞行时的撞击、运动和弹射。 存在高 与这些损伤相关的风险，因为某些解剖 关系。 脊髓圆锥和马尾的连接处是 邻近胸腰椎连接处，脊柱最常见的部位 损伤 此外，在相对刚性的肋骨架和 更灵活的腰椎造成了二次损伤的可能性， 运送到医院和在医院治疗的时间。 治疗 这些伤害在很大程度上取决于 脊柱的稳定/不稳定状态。 虽然有几 在临床指南中，该决定通常基于主观判断。 没有客观的实验研究来帮助医生做到这一点 重要的决定。 我们提案的主要目标是发展这样的 通过产生临床相关的脊柱损伤来提供客观指导， 客观地评估他们的脊柱不稳定性，然后将一个 用另一只手 在新鲜的环境中， 胸腰椎标本，以模拟临床情况。 负载， 位移和变形将被记录在创伤期间，使用 电脑和高速电影摄影机。 X光和CT扫描之前， 创伤后将采取。 将测量多方向不稳定性 在创伤前后。 受伤的标本将被研究 形态学上，它的图像将使用计算机图形学重建 对骨折进行三维可视化。 将分析数据以确定各种类型之间的关系 但是特别是在X射线图像（X射线）之间 和CT扫描）和受伤者的多方向脊柱不稳定性 标本 临床相关性是本研究的主要目的之一， 它可以在诊断水平上参与医疗保健成本控制 和治疗。