Review Article Fractures, Dislocations, and Fracture-Dislocations of the Spine

作者：F. W. Holdsworth · 发表于：Journal of Bone and Joint Surgery · 年份：1970 · DOI：10.2106/00004623-197052080-00002 · 被引用次数：916 · 研究领域：Spinal Fractures and Fixation Techniques、Shoulder and Clavicle Injuries

Over 1000 patients with traumatic paraplegia or tetraplegia and many more with fractures and dislocations of the spine without damage to the central nervous system have been observed and treated at the Sheffield Spinal Injuries Centre. The vertebral lesions with or without injury to the spinal cord or nerve roots have been classified on the basis of the clinical and roentgenographic findings into five groups: 1. Pure flexion which causes a wedge fracture which is stable. 2. Flexion-rotation which produces an unstable fracture-dislocation with rupture of tue posterior ligament complex, separation of the spinous processes, a slice fracture near the upper border of the lower vertebra, and dislocation of the lower articular processes of the upper vertebra. 3. Extension which causes rupture of the intervertebral disc and the anterior common ligament along with avulsion of a small bone fragment from the anterior border of the dislocated vertebra. The dislocation almost always reduces spontaneously and is stable in flexion. 4. Vertebral compression which results in a fracture of the end plate as the nucleus of the intervertebral disc is forced into the vertebral body and causes it to burst with outward displacement of fragments of the body. Since the ligaments remain intact this comminuted fracture is stable. 5. Shearing which results in forward displacement of the whole vertebra and an unstable fracture of the articular processes or pedicles. Accurate diagnosis and prognosis of the...