胸腰椎骨折的研究进展

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1、授予单位代码10089m学号或申请号20123143HebeiMedicalUniversity硕士学位论文专业学位胸腰椎骨折的研究进展研究生：耿涛导师：王鹏程教授专业：外科学二级学院：第三医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名单位为河北医科大学，试验材料、原始数据、申报

2、的专利等知识产权均归河北医科大学所有。否则，承担相应的法律责任。研究生签名：导师签章窣院签韋：丨^"年》月_jo日河北医科大学研究生学位论文独特性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注等内容外，文中不包括其他人已经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名：

3、丨

4、导师签章:^1^0^年；月>曰目录中文摘要····························································

5、····················1英文摘要···············································································2英文缩写···············································································4综述胸腰椎骨折的研究进展解剖与力学特性···············································

6、··················5流行病学··································································6损伤机制及其分型·······························································6椎间盘损伤的临床意义·······················································10胸腰椎骨折伴发椎间盘损伤的转归及影响因素······

7、·············11治疗··············································································13结语···············································································20参考文献·······································································

8、·21致谢·············································································29个人简历············································································30中文摘要胸腰椎骨折的研究进展摘要目的：胸腰椎骨折在临床上极其常见，其发生率报道不一，比较可信的为占全部骨折的5%-6%，占脊柱骨折的70%-80%。胸腰椎骨折的发生率要低于四肢骨

9、折，但是对于外科医生来讲，胸腰椎骨折却比四肢骨折意义更为重大，因为在所有骨折的创伤中，脊柱创伤患者功能的愈后是最差的，重返工作的概率也是最低的，对社会的危害性也高于其他骨折。本文就各种治疗方案的优缺点及适应症，并介绍一些近期最新的研究进展，供大家在为胸腰椎骨折患者治疗时提供参考作用。结论：交通意外和高处坠落伤成为胸腰椎骨折的主要发生因素。脊柱是由多个椎骨依靠椎间盘及椎体间关节和韧带等连接构成的复杂结构。其作用很多，不仅可以支撑躯体、平衡身体各部位的重量、保持重心平稳，还可以吸收作用在脊柱上的应力与震荡，避

10、免脊髓与胸腹内脏器受到损伤。胸腰椎骨折往往合并椎间盘损伤，但是国内外对于胸腰椎骨折合并椎间盘损伤的位置，目前尚无统一定论。胸腰椎骨折常用的分型包括Denis分型、国际内固定研究学会（AO/ASIF）分型、载荷分享评分系统（LSC）、胸腰椎损伤分型及严重程度评分系统，各系统分型各有优缺点，目前尚无哪一种分型能精确指导治疗。对于椎间盘损伤的分型，更是无统一意见，目前比较公认的椎间盘损伤的检测方法为MRI。Oner和Sander等根