腰椎椎弓根应力性骨折：1例报道及文献复习
收稿日期: 2013-08-27
网络出版日期: 2014-04-21
Stress fracture of pedicle of the lumbar vertebra: one case report and literature review
Received date: 2013-08-27
Online published: 2014-04-21
目的 探讨腰椎椎弓根应力性骨折诊断和治疗特点。 方法 回顾分析1例腰椎椎弓根应力性骨折。男性，36岁，柔道运动爱好者，一次柔道练习时感腰痛和腰部活动受限，无神经根刺激症，X线平片未见明显椎弓根骨折，经CT诊断为第五腰椎右侧椎弓根不全性应力性骨折，ODI评分为46%，采取佩戴脊柱支具保守治疗。 结果 6个月后椎弓根骨折愈合，腰痛消失，恢复脊柱正常功能，ODI评分恢复至4%。随访至24个月，患者ODI评分无改变。 结论 腰椎椎弓根应力性骨折发生于脊柱活动量大和重复性多的年轻人，主要外力是扭转力。对于无神经根刺激症的腰椎椎弓根不全性应力性骨折，佩戴脊柱支具保守治疗，效果良好。
孙振中 , 顾三军 , 殷渠东 . 腰椎椎弓根应力性骨折：1例报道及文献复习[J]. 中国临床解剖学杂志, 2014 , 32(2) : 228 -230 . DOI: 10.13418/j.issn.1001-165x.2014
Objective To investigate the characteristics of diagnosis and treatment for pedicle stress fracture of the lumbar vertebra. Methods One case of stress fracture of the pedicle of the fifth lumbar vertebra was retrospectively studied. a 36-years old man, a Judo enthusiast, had low back pain and limitation on lumbar activity but demonstrated no symptom of nerve root irritation in a judo training. Diagnosis of incomplete stress fracture of the right pedicle of the fifth lumbar was missed on plain radiograph but established on CT. The ODI score was 46%, and conservative treatment with the spine brace was advised. Results The fracture healed, low back pain disappeared, the spine restored the normal function and the ODI score recovered to 4% in 6 months. Follow-up of 24 months revealed no change of ODI score. Conclusion Pedicle stress fracture of lumbar occurs in young people with repetitive and large quantity of spinal activity. the main force leading to pedicle stress fracture of lumbar is torsion. For incomplete pedicle stress fracture of lumbar without syndrome of nerve root irritation, conservative treatment with spine brace with acceptable efficacy should take precedence.
Key words： Pedicle stress fracture; Lumbar
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