直腿提升不能取代计算机断层扫描在检测脊柱骨折
Julien Hohenleitner1, Richard Saporito2, Mitchell Hirsch2
1Rutgers New Jersey Medical School, Newark, NJ; Donald and Barbara Zucker School of Medicine at Northwell Health (NSLIJ), Uniondale, NY.
The Journal of surgical research
|December 22, 2023
概括
活跃直腿提升 (SLR) 不能可靠地排除创伤患者的脊柱骨折. 虽然有用,但它的预测值是不够的,需要自由的CT扫描来准确诊断.
科学领域:
- 紧急医疗 紧急医疗
- 整形外科手术 整形外科手术
- 放射学 放射学是一门学科.
背景情况:
- 主动直腿提升 (SLR) 是一种承重测试,用于评估脊柱疼痛和承重能力.
- 计算机断层扫描 (CT) 扫描通常用于脊柱疼痛,可能会使患者暴露在不必要的辐射中.
- 该假设认为,活跃的SLR可以有效排除腰部和胸部脊椎骨折.
研究的目的:
- 评估主动直腿提升 (SLR) 诊断准确度,以识别胸脊椎骨折在重创伤患者中的情况.
- 确定主动单反相机是否可以作为可靠的查工具,以减少对CT扫描的需求.
主要方法:
- 选了99名血液动力学稳定的形创伤患者 (GCS 15,≥18年).
- 患者在12英寸,18英寸和24英寸进行了活跃的SLR,在每个水平上评估疼痛.
- 结果与胸部,腹部和骨盆的标准CT扫描进行了比较.
主要成果:
- 在16% (15/99) 的患者中发现脊柱骨折.
- 在24英寸,主动SLR显示了0.47的灵敏度和0.59.9的特异性.
- 负预测值为0.86,表明错过骨折的发生率很高.
结论:
- 活跃的SLR没有足够的正负预测值来排除胸脊椎骨折.
- 基于损伤机制,疼痛和敏感性的CT扫描的自由指示对于准确的骨折检测至关重要.
- SLR不是一个足够的独立测试,以排除在重创伤中脊柱骨折.
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