Diagnosis and treatment of thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injury / 中华创伤杂志

ABSTRACT

Objective To explore diagnosis and treatment of thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injury. Methods A retrospective study was performed on 84 cases with thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injuries treated in our unit from January 1986 to December 2002, of which there were 52 cases with thoracic vertebra fracture (T_6-T_(12)), 32 with lumbar fracture (L_1-L_4), 70 with complicated chest injury, 14 with abdominal injury and 34 with injuries of cranium, extremities and pelvis. Spinal fixation or decompression of spinal cord was performed in 62 cases, drainage in 22, laparotomy in 10 and exploration of skull in nine. Results Eighty-two cases survived, with follow up period for 6-36 months. According to Frankel standard nerve function recovery showed that among 36 cases at grade A, 10 had partial or sensation recovery and the other got nerve function improvement for gradeⅠ-Ⅲ. Delayed diagnosis and missed injuries totaled seven cases (12%). Two cases were died of postoperative MODS. Conclusions As for patients with thoracolumbar spine and spinal cord trauma complicated by thoracoabdominal viscera injury, a comprehensive clinical examination including X-ray or CT is necessary. The treatment should first focus on thoracoabdominal viscera trauma and try to avoid aggravation of spine and spinal cord injury.