Spinopelvik parametreler torakolomber travmanın şiddetini araç içi trafik kazası ve yüksekten düşme arasında farklı şekilde etkiler mi?

Yıl 2025, Cilt: 18 Sayı: 1, 2 - 2

Veysel Kıyak , Sezer Astan

https://doi.org/10.31362/patd.1477075

Öz

Amaç: Spinopelvik parametrelerin dejeneratif omurga cerrahisi sonrası sonuçlar üzerindeki kapsamlı bir etkisinin karakterizasyonu olmasına rağmen, spinopelvik parametrelerin torakolomber travma üzerindeki etkisi henüz tanımlanmamıştır. Bu çalışmada travma sonrası gelişen vertebra kırıklarının oluşma mekanizması ve tipine göre sagittal spinopelvik parametreler ile arasındaki ilişkinin ortaya konulması amaçlandı.
Gereç ve yöntem: Torakolomber vertebra kırığı olan hastalar retrospektif olarak değerlendirildi. Hastalar araç içi trafik kazası (oturarak travmaya maruz kalan grup) ve yüksekten düşme (ayakta travmaya maruz kalan grup) olmak üzere iki gruba ayrıldı. Bilgisayarlı tomografi görüntülerinde pelvik insidans, pelvik tilt, sakral slop ve vertebral Hounsfield ünitesi değerleri ölçüldü.
Bulgular: Çalışmada yapılan çok değişkenli lojistik regresyon analizi sonuçları, PI'deki bir birimlik artışın, oturan grup travmalarında daha fazla parçalı kırık (A2 ve üzeri) riskini 0,90 kat azalttığını ortaya koydu (Risk oranı: 0,90; 95). %GA: 0,84-0,96; p=0,002) ve ayakta durma pozisyonu travmasında 0,96 kat (Risk oranı: 0,96; %95 GA: 0,93-0,99; p=0,040).
Sonuç: Travma sonrası gelişen vertebra kırıklarında düşük PI'li hastaların vertebral kolonunun daha rijit olmasının kırığın şiddetini arttırdığı görüldü.

Anahtar Kelimeler

Vertebral kırık, Hounsfield ünitesi, pelvik parametreler, AO Spine torakolomber sınıflandırması

Do spinopelvic parameters affect the severity of thoracolumbar trauma differently between in-vehicle traffic accidents and falling from a height?

Öz

Purpose: Although there is a comprehensive characterization of the impact of spinopelvic parameters on
outcomes after degenerative spine surgery, the impact of spinopelvic parameters on thoracolumbar trauma
has not yet been defined. In the present study, it was aimed to reveal the correlation between the severity of
vertebral fractures developing after trauma according to the mechanism of occurrence and sagittal spinopelvic
parameters.
Materials and methods: Patients with thoracolumbar vertebra fractures were evaluated retrospectively. The
patients were divided into two groups: in-vehicle traffic accident (sitting group) and fall from height (standing
group). The pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and vertebral Hounsfield unit (HU) values
were measured on computed tomography (CT) scans.
Results: The results of the multivariate logistic regression analysis performed in the study revealed that a
one-unit increase in PI reduced the risk of more comminuted fractures (A2 and above) by 0.90 times in sitting
position trauma (Odds ratio (OR): 0.90; 95% CI: 0.84-0.96; p=0.002) and by 0.96 times in standing position
trauma (OR: 0.96; 95% CI: 0.93-0.99; p=0.040).
Conclusions: It was observed that in vertebral fractures developed after trauma, the fact that the vertebral
column of patients with low PI is more rigid increased the severity of the fracture.

Anahtar Kelimeler

Vertebral fracture, Hounsfield unit, pelvic parameters, AO Spine thoracolumbar classification

Kaynakça

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