目的總結創傷性腰椎椎弓根骨折（traumatic lumbar pedicle fracture，TLPF）的特點、診斷和治療方法。 方法回顧分析2001年1月和2010年12月收治的2例TLPF男性患者臨床資料，年齡51歲（例1）和29歲（例2）；分別為腰部撞擊致L5右側TLPF伴雙側椎板和雙側橫突骨折，摔倒致L4右側TLPF伴左側峽部不連。2例均有明顯腰痛、腰部活動受限，不能站立，例1有短暫神經根刺激癥狀，例2無神經根刺激癥狀。X線片均未見明顯椎弓根骨折，經CT檢查確診。例1采取L5、S1椎弓根螺釘固定、脊柱后外側植骨融合術治療，例2采取保守治療。 結果例1術后6個月骨折愈合，植骨融合，腰痛基本消失；術后12個月恢復原工作，Oswestry功能障礙指數（ODI）評分由術前92%恢復至6%。例2治療12個月后椎弓根骨折愈合，腰痛消失，恢復脊柱正常功能，ODI評分由治療前60%恢復至4%。 結論TLPF臨床罕見，主要因剪切力和扭轉力暴力致傷，常規X線片檢查易漏診，需行CT或MRI檢查確診，根據具體情況采取手術或保守治療，療效滿意。
引用本文：
殷渠東,顧三軍,孫振中,芮永軍,壽奎水. 創傷性腰椎椎弓根骨折二例報告. 中國修復重建外科雜志, 2013, 27(1): 123-124. doi:
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Vialle R, Mary P, De Carvalho A, et al. Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report. Eur Spine J, 2007, 16 Suppl 3: 316-317.
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Maurer SG, Wright KE, Bendo JA. Iatrogenic spondylolysis leading to contralateral pedicular stress fracture and unstable spondylolisthesis: a case report. Spine (Phila Pa 1976), 2000, 25(7): 895-898.
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- 1. Van Der Heijden C, Claerbout M, Peers K, et al. Traumatic lumbar pedicle fracture associated with pre-existing bilateral spondylolysis and anterolisthesis in a professional soccer player. J Back Musculoskelet, 2007, 20(2): 131-134.
- 2. Vialle R, Mary P, De Carvalho A, et al. Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report. Eur Spine J, 2007, 16 Suppl 3: 316-317.
- 3. Wilkinson RH, Hall JE. The sclerotic pedicle: tumor or pseudotumor? Radiology, 1974, 111(3): 683-688.
- 4. Weatherley CR, Mehdian H, Berghe LV. Low back pain with fracture of the pedicle and contralateral spondylolysis. A technique of surgical management. J Bone Joint Surg (Br), 1991, 73(6): 990-993.
- 5. Sadiq MZ. Bilateral pedicle stress fracture in the lumbar spine of a sedentary office worker. Eur Spine J, 2006, 15 Suppl 5: 653-655.
- 6. Amari R, Sakai T, Katoh S, et al. Fresh stress fractures of lumbar pedicles in an adolescent male ballet dancer: case report and literature review. Arch Orthop Trauma Surg, 2009, 129(3): 397-401.
- 7. Maurer SG, Wright KE, Bendo JA. Iatrogenic spondylolysis leading to contralateral pedicular stress fracture and unstable spondylolisthesis: a case report. Spine (Phila Pa 1976), 2000, 25(7): 895-898.
- 8. Johnson JN, Wang MY. Stress fracture of the lumbar pedicle bilaterally: surgical repair using a percutaneous minimally invasive technique. J Neurosurg Spine, 2009, 11(6): 724-728.
- 9. Garber JE, Wright AM. Unilateral spondylolysis with contralateral pedicle fracture. Spine (Phila Pa 1976), 1986, 11(1): 63-66.
