摘要
选取380例胸腰椎骨折患者作为研究对象,168例胸腰椎骨折后方韧带复合体(PLC)损伤患者为观察组,212例非PLC损伤患者为对照组。通过统计比较发现,两组的载荷分享评分系统(LCS)评分、胸腰椎损伤分类及严重程度(TLICS)评分、Cobb角度、椎体楔变角(SIEA)、局部后凸角(LK)、棘突间距增加值(IISD)相比,差异有统计学意义(P<0.05);CT骨性影像学参数联合诊断胸腰椎骨折PLC损伤的敏感度为72.41%、特异度为87.33%;预后不良患者术前及术后3 d的SIEA、LK、IISD均高于预后良好患者(P<0.05);术后3 d,SIEA、LK、IISD的AUC值均高于术前,且联合预测胸腰椎骨折PLC损伤患者预后的AUC值最高,为0.869。SIEA、LK、IISD为胸腰椎骨折PLC损伤的危险影响因素,三者结合可为临床诊断胸腰椎骨折PLC损伤及预测预后提供参考。
A total of 380 patients with thoracolumbar fracture were selected as the research objects,which were 168 patients with thoracolumbar fractures and posterior ligamentous complex(PLC)injuries as the observation group,and 212 patients without PLC injuries a the control group.Through statistical comparison,it was found that the load-sharing classification system(LCS)score,thoracolumbar injury classification and severity(TLICS)score,Cobb angle,SIEA,LK,and IISD were significantly different between the two groups(P<0.05).The sensitivity of the diagnosis of PLC injury in thoracolumbar fractures through the combination of CT bone imaging parameters was 72.41%and the specificity was 87.33%.The SIEA,LK and IISD of patients with poor prognosis before and 3 days after operation were higher than those with good prognosis(P<0.05).The AUC of SIEA,LK,and IISD 3 days after surgery were higher than those of preoperatively,and the AUC of combined prediction of PLC injury in thoracolumbar fractures was the highest,which was 0.869.The best sensitivity and specificity were 72.62%and 87.26%,respectively.Therefore,it can be considered that SIEA,LK,and IISD are the risk factors for PLC injury of thoracolumbar fractures,and the combination of the three can provide references for clinical diagnosis of PLC injury of thoracolumbar fractures and prediction of prognosis.
作者
朱思光
孙涛
ZHU Siguang;SUN Tao(Department of Radiology,Baoshan Branch,Baoshan Renhe Hospital/Huashan Hospital,Shanghai 200431,P.R.China;Department of Radiology,Jiangsu Provincial People’s Hospital,Nanjing 210029,Jiangsu,P.R.China)
出处
《影像科学与光化学》
CAS
北大核心
2021年第4期589-594,共6页
Imaging Science and Photochemistry
