| Trauma of the thoracolumbar spine is a common and serious disease. Conventional imageologic methods including conventional X-ray, CT and MR are helpful to the spinal trauma. Spiral CT and 3DCT are superior in making diagnosis and directing management and playing a important role in spinal trauma. Research Purposes1. To explore the suitable conditions in SCT scan, especially the role of pitch. Through the model to study the physical foundation of spinal fracture.2. To compare several SCT three-dimentional reconstruction methods and determine several basic reconstruction positions.3. To evaluate the clinical value of SCT and its reconstruction effect in spinal trauma. To analyze several anatomical structures concerned with spinal injury from the point of SCT.4. To study the imageologic classification of spine injury. To determine the solidity of spine from the image of SCT.5. To analyze the relationship between the SCT images and the clinical symptoms.6. To evaluate the role of SCT image in surgical treatment and postoperation.of spinal injury.7. To analyze several imaging modalities, including conventional X-ray, CT, 3DCT and MR in spinal fracture diagnosis.Research Methods.1. Experiment study: SCT images were obtained after changing pitch.at the following stages: intact and immediately after creation of vertebral fracture.2. Rendom selected 25 cases of normal spines to search basic reconstruction positions.3. 60 cases of spinal fractures were diagnosed by SCT. The following were paid more attention.(l)location of fracture.(2)relationship between the fracture type and fracture- 8 -location.(3)the SCT image of fracture, including the intracanal fragment and vertebral canal compromise, vertebral body height, and kyphosis angle before and after operation. Compare the restoration of them.(4)classify spine injury.(5)determine the solidity of spine.(6)determine and evaluate the location of insertion before and after operation.4. According to Frankel neurologic types compare the SCT images and clinical symptoms of spinal fracture.5. Contrast the value of X-ray, SCT and MR in diagnosis of spinal injury.6. Statistics analysis.Results1. Fixing the thickness and interval , the smaller pitch make the clearer image while no more information added. Axial pressure can make flexion and burst fracture.2. Except for three positions in MPR structures of spine can be showed clearly at eight various positions of 3-dimentional .3. SCT findings of spinal fracture.(1) The fracture incidence of thoracic, lumbar, thoracolumbar are 59.2%, 40.8%, 55% respectively o(2) The incidence of compressive fracture, burst fracture, flexion and stretch fracture, flexion and rotation fracture, horizontal shift dislocation are 23.3%, 48.4%, 10%, 15%, 3.3%respectively.(3) The initial spinal canal area decrease to 42.3% (17.6%-76.7%) and after operation restored to 57 ?7% (37%-82.4%) .This is statistics significant (p<0.01). Significant correlation is observed between the canal clearance of the injured spine and canal clearance after operation (R2=0.803).(4) .Initial kyphosis deformity is 26.1?(15.6?-43.8?)and is corrected to 4.3? (8.2?-1.6? ) after operation.(5) Initial vertebral body height decrease to 51.3% (28.6%-86%) and is restored to 95.4% (84.2%-106.7%) . No significant correlation is observed between the canal compromise and loss of the posterior vertebral height (R2=0.04).-9-(6) The incidence of unsolidity fracture is 72.1% including 76.4% of burst fracture,37.5% of flexion and compression fracture and all of rotation and flexion injury and flexion stretch fracture and horizontal dislocation . 40% of post elements ,58.3% of post and middle elements and 31.7% of three elements are involved. All of them are unsolidity fractures. The incidence of solidity fracture is 27.9% including simple flexion and compression fracture and 23.6% of burst fracture.(7) SCT as a guideline is succeed used in 17 cases of... |
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