创伤性腰椎椎弓根骨折二例报告_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

殷渠东 , 顾三军 , 孙振中 , 芮永军 , 寿奎水

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Keywords：

创伤性腰椎椎弓根骨折; 脊柱融合术; 诊治方法

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目的总结创伤性腰椎椎弓根骨折（traumatic lumbar pedicle fracture，TLPF）的特点、诊断和治疗方法。方法回顾分析2001年1月和2010年12月收治的2例TLPF男性患者临床资料，年龄51岁（例1）和29岁（例2）；分别为腰部撞击致L5右侧TLPF伴双侧椎板和双侧横突骨折，摔倒致L4右侧TLPF伴左侧峡部不连。2例均有明显腰痛、腰部活动受限，不能站立，例1有短暂神经根刺激症状，例2无神经根刺激症状。X线片均未见明显椎弓根骨折，经CT检查确诊。例1采取L5、S1椎弓根螺钉固定、脊柱后外侧植骨融合术治疗，例2采取保守治疗。结果例1术后6个月骨折愈合，植骨融合，腰痛基本消失；术后12个月恢复原工作，Oswestry功能障碍指数（ODI）评分由术前92%恢复至6%。例2治疗12个月后椎弓根骨折愈合，腰痛消失，恢复脊柱正常功能，ODI评分由治疗前60%恢复至4%。结论TLPF临床罕见，主要因剪切力和扭转力暴力致伤，常规X线片检查易漏诊，需行CT或MRI检查确诊，根据具体情况采取手术或保守治疗，疗效满意。

Citation： 殷渠东,顾三军,孙振中,芮永军,寿奎水. 创伤性腰椎椎弓根骨折二例报告. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(1): 123-124. doi: Copy

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2.	Vialle R, Mary P, De Carvalho A, et al. Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report. Eur Spine J, 2007, 16 Suppl 3: 316-317.
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1. Van Der Heijden C, Claerbout M, Peers K, et al. Traumatic lumbar pedicle fracture associated with pre-existing bilateral spondylolysis and anterolisthesis in a professional soccer player. J Back Musculoskelet, 2007, 20(2): 131-134.
2. Vialle R, Mary P, De Carvalho A, et al. Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report. Eur Spine J, 2007, 16 Suppl 3: 316-317.
3. Wilkinson RH, Hall JE. The sclerotic pedicle: tumor or pseudotumor? Radiology, 1974, 111(3): 683-688.
4. Weatherley CR, Mehdian H, Berghe LV. Low back pain with fracture of the pedicle and contralateral spondylolysis. A technique of surgical management. J Bone Joint Surg (Br), 1991, 73(6): 990-993.
5. Sadiq MZ. Bilateral pedicle stress fracture in the lumbar spine of a sedentary office worker. Eur Spine J, 2006, 15 Suppl 5: 653-655.
6. Amari R, Sakai T, Katoh S, et al. Fresh stress fractures of lumbar pedicles in an adolescent male ballet dancer: case report and literature review. Arch Orthop Trauma Surg, 2009, 129(3): 397-401.
7. Maurer SG, Wright KE, Bendo JA. Iatrogenic spondylolysis leading to contralateral pedicular stress fracture and unstable spondylolisthesis: a case report. Spine (Phila Pa 1976), 2000, 25(7): 895-898.
8. Johnson JN, Wang MY. Stress fracture of the lumbar pedicle bilaterally: surgical repair using a percutaneous minimally invasive technique. J Neurosurg Spine, 2009, 11(6): 724-728.
9. Garber JE, Wright AM. Unilateral spondylolysis with contralateral pedicle fracture. Spine (Phila Pa 1976), 1986, 11(1): 63-66.

Chinese Journal of Reparative and Reconstructive Surgery

创伤性腰椎椎弓根骨折二例报告

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