[问题] 胸腰椎骨折

楼主: shocked15 (房间大扫除)   2023-03-15 14:55:17
女性长辈72岁,上星期五在弯腰帮忙时,被重物砸到背上,当场趴在地上极度疼痛,无法
动弹,被救护车送急诊室。
在急诊室照CT说是T4、L1、L4有compression fracture,打了强效止痛跟类固醇,之后MR
I检查说没有问题,需要休养。双脚在住院时持续抽筋,而且无法移动,需要两个人从床
上拉起扛着才能用移动式马桶。
IMPRESSION:
T4 and L1 compression fractures. At L1, there is mild retropulsian and mild ca
nal stenosis overall. There is a compression fracture of the T4 vertebral body
with mild retropulsion
inferiorly and no significant canal stenosis as a result.
There is also an acute compression fracture of L1 with mild retropulsion and o
verall mild canal stenosis. No other fractures are identified.
There is a compression fracture of the l4 vertebral body with mild retropulsio
n and overall mild canal stenosis.
There is 6 min anterior subluxation of L4 on L5 from facet hypertrophy.
At L4-LS, there is mild canal stenosis. There is inferior neural foraminal nar
rowing without significant nerve toot encroacation:
IMPRESSION:
1. L1 compression fracture with mild retropulsion and overall mild canal steno
sis.
2.6 mm anterior subluxation of L4 on L5 secondary to mild facet hypertrophy.
There is resultant mild canal stenosis
星期一被转到疗养院至今,今天事发第五天,长辈还是无法自行坐起,而且双脚还是在抽
筋。因为是美国乡下小医院,家人怕误诊而延误治疗,毕竟是有下半身瘫痪的可能,想请
问大家的意见。是否应该另外找医生做检查看骨折地方有没有需要做手术或是神经检查看
有没有影响神经?还是应该持续休养,不要乱移动?如果休养的话,请问大约复原时间?
谢谢大家的意见。
作者: GarciaWu (Let's Go Yankees !)   2023-03-15 21:22:00
看起来L1是急性压迫性骨折,不想躺那么久的话可以考虑灌骨水泥, 美国的话费用应该蛮可观的
楼主: shocked15 (房间大扫除)   2023-03-16 03:44:00
请问如果长期休养复健会好吗?怕手术反而会有后遗症更糟糕。
作者: johnyang (Saico)   2023-03-30 20:31:00
看报告似乎是没有严重神经压迫 请确认脚踝脚趾可否正常活动 另外一定要穿背架 至于骨水泥在急性期渗漏风险较高 请审慎斟酌

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