目的總結(jié)創(chuàng)傷性腰椎椎弓根骨折（traumatic lumbar pedicle fracture，TLPF）的特點(diǎn)、診斷和治療方法。 方法回顧分析2001年1月和2010年12月收治的2例TLPF男性患者臨床資料，年齡51歲（例1）和29歲（例2）；分別為腰部撞擊致L5右側(cè)TLPF伴雙側(cè)椎板和雙側(cè)橫突骨折，摔倒致L4右側(cè)TLPF伴左側(cè)峽部不連。2例均有明顯腰痛、腰部活動(dòng)受限，不能站立，例1有短暫神經(jīng)根刺激癥狀，例2無神經(jīng)根刺激癥狀。X線片均未見明顯椎弓根骨折，經(jīng)CT檢查確診。例1采取L5、S1椎弓根螺釘固定、脊柱后外側(cè)植骨融合術(shù)治療，例2采取保守治療。 結(jié)果例1術(shù)后6個(gè)月骨折愈合，植骨融合，腰痛基本消失；術(shù)后12個(gè)月恢復(fù)原工作，Oswestry功能障礙指數(shù)（ODI）評(píng)分由術(shù)前92%恢復(fù)至6%。例2治療12個(gè)月后椎弓根骨折愈合，腰痛消失，恢復(fù)脊柱正常功能，ODI評(píng)分由治療前60%恢復(fù)至4%。 結(jié)論TLPF臨床罕見，主要因剪切力和扭轉(zhuǎn)力暴力致傷，常規(guī)X線片檢查易漏診，需行CT或MRI檢查確診，根據(jù)具體情況采取手術(shù)或保守治療，療效滿意。
引用本文： 殷渠東,顧三軍,孫振中,芮永軍,壽奎水. 創(chuàng)傷性腰椎椎弓根骨折二例報(bào)告. 中國(guó)修復(fù)重建外科雜志, 2013, 27(1): 123-124. doi: 復(fù)制
| 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. |
- 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.