자기공명촬영으로 조사한 흉요추 골절 환자의 추간판 손상

Abstract

Injury to a lumbar disc is rare, and is seldom mentioned in the literature describing spinal fracture; even in patients with such fractures, disc herniation is infrequent and is often considered to be a sequella of trauma. Using magnetic resonance imaging(MRI) we investigated the incidence and pattern of disc injuries by an in 37 patients with fractures of the lumbar and thoracic spines. Discs adjacent to the fracture site were found to be normal in 19 patients(51.4%), but in ten(27.0%), the end plate was disrupted. The disc was ruptured in six patients(16.2%), and had degenerated in two patients(5.4%). Injured discs were found in the three patients with fracture-dislocation and three of the seven(42.9%) with burst fracture, but in none of the 27 with compression fracture. The three lower lumbar discs(L3-4, L4-5, and L5-S1) were found to be normal in 26 patients(70.3%), but had degenerated in seven(18.9%). Incidental asymptomatic disc herniation was found in four patients(10.8%), including one with degenerative spondylolisthesis. There was no traumatic disc herniation in the lower lumbar region. These results suggest that traumatic lumbar disc herniation is quite uncommon, even in the unstable thoracolumbar spinal injuries.