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[1]謝國(guó)華,薛峰,楊建平,等.強(qiáng)直性脊柱炎脊柱應(yīng)力性骨折的診斷[J].中醫(yī)正骨,2012,24(12):72-74.
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強(qiáng)直性脊柱炎脊柱應(yīng)力性骨折的診斷()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期數(shù):
2012年12期
頁(yè)碼:
72-74
欄目:
脊柱損傷
出版日期:
2012-12-20

文章信息/Info

作者:
謝國(guó)華薛峰楊建平牟曉峰陸根華
江蘇省常州市中醫(yī)醫(yī)院,江蘇 常州 213000
關(guān)鍵詞:
脊柱炎強(qiáng)直性 脊柱骨折 診斷
摘要:
目的:探討強(qiáng)直性脊柱炎脊柱應(yīng)力性骨折的臨床表現(xiàn)、血液檢查結(jié)果及影像學(xué)特點(diǎn),為該病的臨床診斷提供參考。方法:2000年6月至2010年6月,治療強(qiáng)直性脊柱炎脊柱應(yīng)力性骨折患者11例,男8例,女3例; 年齡29~65歲,中位數(shù)48歲。骨折部位:T101例,T10、T113例,T11、T124例,T12、L12例,L1、L21例。對(duì)11例患者的病例資料進(jìn)行回顧性分析,總結(jié)其臨床表現(xiàn)、血液檢查結(jié)果及影像表現(xiàn)的特點(diǎn)。結(jié)果:11例患者均有腰背部疼痛癥狀,均有不同程度的胸腰段脊柱后凸畸形。有脊髓損傷表現(xiàn)3例,骨折部位均有明顯壓痛,雙下肢肌力均為4級(jí),感覺減退,膝腱和跟腱反射減弱,Frankel分級(jí)為D級(jí)。血清人類白細(xì)胞抗原-B27均為陽(yáng)性; 類風(fēng)濕3項(xiàng)檢查均為陰性; 血沉20~30 mm·h-13例,低于10 mm·h-18例。脊柱X線片均顯示椎間盤及脊柱周圍韌帶有明顯的骨化,椎體間已形成骨橋,椎體變方,呈典型的“竹節(jié)樣”改變,且有骨質(zhì)疏松表現(xiàn),骨折椎體終板骨質(zhì)破壞,形狀不規(guī)則; 骶髂關(guān)節(jié)正位X線片顯示關(guān)節(jié)間隙消失。CT重建片顯示骨折均累及脊柱三柱,其中有明顯脫位2例; 骨折線經(jīng)過T10椎體1例,其余骨折線均位于椎間隙; 矢狀位見骨折端相鄰椎體的終板面或骨折斷端有廣泛的骨質(zhì)破壞,邊緣不整,周圍骨質(zhì)硬化,有假關(guān)節(jié)形成。MRI檢查顯示骨折節(jié)段有不規(guī)則的低信號(hào)影貫穿脊柱的前、中、后柱,T1加權(quán)像骨折節(jié)段均表現(xiàn)為低信號(hào)影,T2加權(quán)像低信號(hào)9例,高信號(hào)2例; 椎管內(nèi)脊髓有受壓表現(xiàn)3例,其中骨折端脫位2例,椎管內(nèi)血腫壓迫1例。結(jié)論:對(duì)于脊柱疼痛突然加重或后凸畸形急劇進(jìn)展的強(qiáng)直性脊柱炎患者,無論是否有外傷史,都應(yīng)高度懷疑脊柱骨折。強(qiáng)直性脊柱炎脊柱應(yīng)力性骨折血液檢查常見血清人類白細(xì)胞抗原-B27陽(yáng)性,類風(fēng)濕3項(xiàng)陰性; X線表現(xiàn)為脊柱呈典型的“竹節(jié)樣”改變,骨折椎體終板骨質(zhì)破壞,形狀不規(guī)則; CT及 MRI重建可見骨折累及脊柱三柱。

參考文獻(xiàn)/References:

[1] Mrabet D,Alaya Z,Mizouni H,et al.Spine fracture in patient with ankylosing spondylitis:A case report[J].Ann Phys Rehabil Med,2010,53(10):643-649.
[2] Vosse D,Feldtkeller E,Erlendsson J,et al.Clinical vertebral fractures in patients with ankylosing spondylitis[J].J Rheumatol,2004,31(10):1981-1985.
[3] Samartzis D,Anderson DG,Shen FH.Multiple and simultaneous spine fractures in ankylosing spondylitis:case report[J].Spine,2005,30(23):E711-715.
[4] Kim KT,Lee SH,Suk KS,et al.Spinal pseudoarthrosis in advanced ankylosing spondylitis with sagittal plane deformity:clinical characteristics and outcome analysis[J].Spine,2007,32(15):1641-1647.
[5] Chang KW,Tu MY,Huang HH,et al.Posterior correction and fixation without anterior fusion for pseudoarthrosis with kyphotic deformity in ankylosing spondylitis[J].Spine,2006,31(13):E408-413.
[6] Wade W,Saltzstein R,Maiman D.Spinal fractures complicating ankylosing spondylitis[J].Arch Phys Med Rehabil,1989,70(5):398-401.
[7] Cooper C,Carbone L,Michet CJ,et al.Fracture risk in patients with ankylosing spondylitis:A population based study[J].J Rheumatol,1994,21(10):1877-1882.
[8] Taggard DA,Traynelis VC.Management of cervical spinal fractures in ankylosing spondylitis with posterior fixation[J].Spin(Phila Pa 1976),2000,25(16):2035-2039.
[9] Detwiler KN,Loftus CM,Godersky JC,et al.Management of cervical spine injuries in patients with ankylosing spondylitis[J].Neurosurg,1990,72(2):210-215.
[10] Unsal E,Arici AM,Kavukçu S,et al.Andersson lesion:spondylitis erosiva in adolescents.Two cases and review of the literature[J].Pediatr radiol,2002,32(3):183-187.
[11] 李維,吳強(qiáng),余梅貴.HLA-B27亞型及其與強(qiáng)直性脊柱炎關(guān)系的研究進(jìn)展[J].免疫學(xué)雜志,2002,18(3):191-194.

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更新日期/Last Update: 2012-12-20