胸腰段骨折椎体邻近椎间盘的MRI影像学特点及临床意义

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Abstract Objective To evaluate the mid and short term changes of vertebral disc adjacent to thoracolumbar burst fracture and summarize its imaging characteristics and clinical significance on MRI.Methods The MRI data of 25 patients with thoracolumbar fracture in the Second Hospital of Shanxi Medical University from May 2020 to May 2021 were collected，including 19 males and 6 females.The age ranged from 29 to 56 years，with an average of (41.08±7.10)years.There were 3 T₁₂ fractures，14 L₁fractures and 8 L₂ fractures.MRI data were recorded before surgery and one week before internal fixation removal (internal fixation was removed at an average of 10 months).Morphological characteristics and signal changes of 50 intervertebral discs adjacent to the fractured vertebral body were observed on T₂WI，and their characteristics were summarized.Visual analogue scale (VAS) and The Oswestry disability index (ODI) were compared after surgery and removal of internal fixation.Results 86% of the 21 discs with normal signal on T₂WI prior to reduction showed normal signal when the implants were removed.Of the 19 discs with increased signal intensity on T₂WI prior to treatment，42% returned to normal at the time of removal，16% had high signal intensity，26% had decreased signal intensity，and 16% had disc signal loss.Of the 10 discs with decreased signal on T₂WI before reduction，only 1 disc returned to normal.In 19 intact interverte bral disc (CategoryⅠ)，a total of 79% of the intervertebral disc kept its structural integrity.In 29 slightly damaged intervertebral disc (CategoryⅡ)，7% of the intervertebral discs recovered to the category 1，when internal fixation was removed.62% of the intervertebral disc remains the same，and 31% of the intervertebral disc structure deteriorated (Category Ⅲ).There were statistically significant differences in VAS and ODI after surgery compared with those after internal fixation (P<0.05).Conclusion Some patients with thoracolumbar fracture will have intervertebral disc injury.Clinically，the changes of intervertebral disc signal and shape on MRI is one of the important reference factors in the selection of treatment.If the signal and shape of the disc are intact or slightly changed，simple posterior distraction reduction and internal fixation is feasible.If serious morphological changes occur on the basis of changes in intervertebral disc signals，the VAS and ODI scores of such patients will be worse after the removal of internal fixation，and complications such as kyphosis may occur in the long term.Therefore，fusion surgery should be considered as appropriate.

Key words： thoracolumbar fracture intervertebral disc imaging features fusion treatment

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	Wang Jiajia 1
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	Song Wenhui 2*
	Liang Kaiheng 2
	Bao Kai 1
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Wang Jiajia 1,2,Song Wenhui 2*, et al. Features and Clinical Significance on MRI of the Adjacent Intervertebral Discs in Thoracolumbar Fractures[J]. sygkzz, 2022, 28(6): 481-486.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I6/481

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