SPINAL INJURIES OF THORACOLUMBAR SPINE

胸腰椎脊髓损伤

• 批准号: 3159188
• 负责人: MANOHAR M PANJABI
• 金额: $ 23.06万
• 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/3159188
• 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.

脊柱胸腰段骨折严重致残 伤害造成个人痛苦和重大社会损失的。 这些原因有很多，比如高速车祸、坠落、 飞行员在高速飞行时的击打、运动和弹射。有很高的 与这些损伤相关的风险，因为某些解剖结构 两性关系。脊髓圆锥与马尾神经的交界处 毗邻胸腰椎交界处，脊柱最常见的部位 受伤。此外，相对刚性的肋骨和肋骨之间的这种连接 更灵活的腰椎在以下情况下可能造成二次损伤 运送到医院的时间和在医院的治疗时间。治疗的方法 这些伤害在很大程度上取决于 脊柱的稳定性/不稳定状态。尽管有几个 临床指南中，决策往往是基于主观判断。 没有客观的实验研究来帮助医生做到这一点 重要的决定。我们建议的主要目标是发展这样的 目的通过产生临床相关的脊柱损伤来制定指南， 客观地评估他们的脊柱不稳定，然后将其中一个 和另一只。 在新鲜情况下会动态产生骨折和错位 胸腰椎标本模拟临床情况。负重， 创伤期间的位移和变形将被记录下来，使用 电脑和高速电影摄影机。之前和之后的X光和CT扫描 创伤后就会被带走。将测量多方向不稳定性 在创伤之前和之后。将对受伤的标本进行研究 在形态上，它的图像将使用计算机图形学重建 用于骨折的三维可视化。 将对数据进行分析，以确定各种类型之间的关系 参数，尤其是在X射线图像(x射线)之间 和CT扫描)和伤者的多向脊柱不稳 标本。临床相关性是本研究的主要目的之一， 它可以在诊断层面上参与医疗费用控制。 和治疗。