胸腰椎屈曲牵张型损伤的研究进展△（开放获取）

Research progress in thoracolumbar flexiondistraction injury

摘要:

屈曲牵张型损伤（flexion distraction injury, FDI） 为脊柱三柱损伤，好发于胸腰椎，特点为棘突或后方韧带复合体（posterior ligamentous complex, PLC） 损伤，可伴有椎体压缩骨折或爆裂骨折，Chance 骨折仅为FDI 的一个亚型。在临床中，可能更关注显而易见的椎体骨折及神经压迫，而对胸腰椎屈曲牵张型损伤（thoracolumbar flexion distraction injury, TLFDI） 认识不足，容易漏诊误诊，阻碍了临床治疗方案的选择。不当的治疗方案会导致脊柱不稳以及神经功能恶化等。本文旨在对目前TLFDI 的损伤机制、临床分型、诊断方法、治疗方案选择及是否去除内固定的相关研究进展进行综述，以期加强临床医生对此类损伤的认识，为TLFDI 临床治疗提供参考。

Abstract:

The flexion-distraction injury (FDI) is a three-column spinal injury commonly occurring in the thoracolumbar region, charac-terized by damage to the spinous process or the posterior ligamentous complex (PLC). It is often accompanied by vertebral compression frac-tures or burst fractures, while Chance fractures represent only one subtype of FDI. In clinical setting, the attention is often given to the moreapparent vertebral fractures and neural compression, while understanding to thoracolumbar flexion-distraction injuries (TLFDI) remains in-adequate, which usually leads to misdiagnosis and missed diagnosis, and hampers appropriate selection of treatment plans. Inproper treat-ment strategies can result in spinal instability and worsening of neurological function. This article aims to review the current progress in theinjury mechanism, clinical classification, diagnostic methods, treatment options, and the debate on whether to remove internal fixation forTLFDI, to enhance clinicians' understanding of these injuries and provide a reference for clinical decision-making in TLFDI management.