同: 椎体破裂骨折

WordNet

move suddenly, energetically, or violently; "He burst out of the house into the cool night"
break open or apart suddenly and forcefully; "The dam burst" (同)bust
come open suddenly and violently, as if from internal pressure; "The bubble burst" (同)split, break_open
a sudden flurry of activity (often for no obvious reason); "a burst of applause"; "a fit of housecleaning" (同)fit
emerge suddenly; "The sun burst into view"
interrupt, break, or destroy; "fracture the balance of power"
breaking of hard tissue such as bone; "it was a nasty fracture"; "the break seems to have been caused by a fall" (同)break
fracture a bone of; "I broke my foot while playing hockey" (同)break
become fractured; "The tibia fractured from the blow of the iron pipe"
break (a bone); "She broke her clavicle"
break into pieces; "The pothole fractured a bolt on the axle"
violate or abuse; "This writer really fractures the language"
the act of cracking something (同)crack, cracking
remove the burrs from (同)burr
seed vessel having hooks or prickles (同)burr
small bit used in dentistry or surgery (同)burr

PrepTutorEJDIC

『破裂する』,爆発する / 〈つぼみが〉ほころびる / 《通例進行形で》(…で)はちきれそうにいっぱいである《+『with』+『名』》 / 『急に(…)する』 / …'を'破裂させる,爆発させる,破る / (…の)『破裂』,爆発《+『of』+『名』》 / (…の)『突発』《+『of』+『名』》
〈U〉(特に)骨を折ること;骨を折った状熊 / 〈C〉割れ(裂け)目,(鉱物の)破砕面 / 〈足・腕などを〉‘を'骨折する;…‘を'砕く / 骨折する;砕ける

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/11/13 00:40:15」(JST)

wiki en

A burst fracture is a type of traumatic [spinal injury] in which a vertebra breaks from a high-energy axial load (e.g., traffic collisions or falls from a great height or high speed, and some kinds of seizures), with shards of vertebra penetrating surrounding tissues and sometimes the spinal canal.^[1] The burst fracture is categorized by the "severity of the deformity, the severity of (spinal) canal compromise, the degree of loss of vertebral body height, and the degree of neurologic deficit."^[2] Burst fractures are considered more severe than compression fractures because long-term neurological damage can follow. The neurologic deficits can reach their full extent immediately, or can progress for a prolonged time.

Treatment

Immediate hospitalization is required, as such injuries may result in varying degrees of spinal cord injury with possible paralysis. X-rays and MRIs are taken to determine whether the burst fracture can be managed with or without surgery.^[3] Surgical management is required when the burst fracture is unstable. Predicting spinal instability of vertebral thoracic lumbar fractures is based on several radiologic and clinical parameters. Efforts to refine fracture classification schemes to better predict instability continue. Application of axial zone model proposed by physicians at Barrow Neurological Institute may enhance the ability to predict stability, depending not only on the number of columns, but also on the number of zones involved in the injuries. Further clinical and biomechanical studies are warranted to validate this model.^[4]

Different surgical treatments are available, the most common involving fusion of the remaining vertebra in the traumatized area, and removal of the larger loose vertebra pieces. A "spinal fusion" surgery entails two or more vertebra are permanently immobilized through surgery using titanium implants. Another less common technique is to replace the burst vertebra with an artificial bone^[5] or cadaver bone. Both latter strategies have been used successfully in elderly subjects, and has not yet been attempted in younger subjects due to the unknown stability over the long term.

Nonsurgical management is possible when the burst fracture subject is intact neurologically. Nonsurgical treatment involves the use of a full-body, exterior brace, normally a Thoracic Lumbar Sacral Orthosis (TLSO), often custom-molded to the subject's body. X-rays and MRIs are again taken with the subject every 2 weeks in the TLSO to determine whether the spine will remain stable. The TLSO is worn for 2–3 months 24/7. The subject undergoes several months of physical therapy to strengthen atrophied muscles and basically learn how to walk again. It is probable that the subject may exhibit some spinal dislocation after removal of the TLSO,^[6] and it is well within expected parameters with little neurological impact experienced by month 3. If no further major dislocation or subluxation occurs, no other external stabilization may be required.

Prognosis

In the long-term, varying degrees of pain, function, and appearance may affect the traumatized region during the subject's lifetime. A burst fracture results in a permanent decrease in anterior height, varying degrees of kyphosis,^[7] and possible changes in neurological signal intensity with possible deterioration over time. Over the subject's lifetime, the subject experiences ancillary pain and discomfort in the spine and limbs caused by increasing neurological dysfunction.

References

^ Burst Fracture
^ Lumbar Fractures: Compression, Wedge, Burst, Flexion-distraction
^ Burst Fracture: surgery or not
^ Radiographic Assessment of Thoracolumbar Fractures based on Axial Zones
^ Vertebral Bone Replacement
^ Removal of the TLSO in Burst Fractures
^ Kyphosis info

[1], retrieved November 14, 2005.

External links

Information for patients - spinal trauma - Oxford Clinic

UpToDate Contents

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1. 成人における脊髄損傷：定義、機序、および放射線学的所見 spinal column injuries in adults definitions mechanisms and radiographs
2. 胸腰椎脊柱損傷の評価 evaluation of thoracic and lumbar spinal column injury
3. 骨粗鬆症による胸腰椎圧迫骨折：臨床症状および医療 osteoporotic thoracolumbar vertebral compression fractures clinical manifestations and treatment
4. 児童虐待の整形外科的側面 orthopedic aspects of child abuse
5. 成人における鈍的胸部外傷の初期評価およびマネージメント initial evaluation and management of blunt thoracic trauma in adults

English Journal

Detection and characterization of stainless steel SCC by the analysis of crack related acoustic emission.

Kovač J1, Legat A1, Zajec B1, Kosec T1, Govekar E2.
Ultrasonics.Ultrasonics.2015 Sep;62:312-22. doi: 10.1016/j.ultras.2015.06.005. Epub 2015 Jun 11.
In the paper the results of the acoustic emission (AE) based detection and characterization of stress-corrosion cracking (SCC) in stainless steel are presented. As supportive methods for AE interpretation, electrochemical noise, specimen elongation measurements, and digital imaging of the specimen s
PMID 26112425

Treatment with or without an Orthosis is Equivalent for Thoracolumbar Burst Fracture without Neurologic Injury.

Schwab F1.
The Journal of bone and joint surgery. American volume.J Bone Joint Surg Am.2015 Aug 19;97(16):1374. doi: 10.2106/JBJS.9716.ebo103.
PMID 26290091

Transpedicular Corpectomy and Cage Placement in the Treatment of Traumatic Lumbar Burst Fractures.

Pham MH1, Tuchman A, Chen TC, Acosta FL, Hsieh PC, Liu JC.
Journal of spinal disorders & techniques.J Spinal Disord Tech.2015 Aug 19. [Epub ahead of print]
STUDY DESIGN: Retrospective review.OBJECTIVE: To review the feasibility of a posterior-only approach for instrumented reconstruction in lumbar burst fractures.BACKGROUND: Burst fractures of the lumbar spine have been treated through a variety of techniques, including anterior, posterior, or combined
PMID 26301730