PDF(Pubmed)
Abstract：
Pneumorrhachis (PR) is defined as presence of free air in the spinal canal. Traumatic PR is very rare, and its exact incidence and pathogenesis is unknown. A comprehensive literature search was performed using the PubMed, Cochrane Library, Google Scholar and Scopus databases to identify articles relevant to traumatic PR published till January 2023. A total of 34 resources were selected for inclusion in this narrative review. Traumatic PR can be classified anatomically into epidural and intradural types. In the epidural type, air is present peripherally in the spinal canal and the patients are usually asymptomatic. In contrast, in intradural PR, air is seen centrally in the spinal canal and patients present with neurological symptoms, and it is a marker of severe trauma. It is frequently associated with traumatic pneumocephalus, skull fractures or thoracic spine fracture. Computed tomography (CT) is considered to be the diagnostic modality of choice. Epidural PR is self-limited and patients are generally managed conservatively. Patients with neurological symptoms or persistent air in spinal canal require further evaluation for a potential source of air leak, with a need for surgical intervention. Differentiation between epidural and intradural PR is important, because the latter is an indication of severe underlying injury. CT imaging of the entire spine must be performed to look for extension of air, as well as to identify concomitant skull, torso or spinal injuries Most patients are asymptomatic and are managed conservatively, but a few may develop neurological symptoms that need further evaluation and management.
摘要：
肺出血（PR）定义为椎管中存在自由空气。创伤公关非常罕见，其确切发病率和发病机制尚不清楚。使用PubMed进行了全面的文献检索，科克伦图书馆,谷歌学者和Scopus数据库，以确定截至2023年1月发表的与创伤公关相关的文章。总共选择了34个资源纳入本叙述审查。创伤性PR可以在解剖学上分为硬膜外和硬膜内类型。在硬膜外类型中，椎管周围存在空气，患者通常无症状。相比之下,在硬膜内PR中，空气在椎管中央可见，患者出现神经系统症状，是严重创伤的标志.它经常与外伤性气颅有关，颅骨骨折或胸椎骨折。计算机断层扫描（CT）被认为是首选的诊断方式。硬膜外PR是自我限制的，患者通常接受保守管理。有神经症状或椎管内持续存在空气的患者需要进一步评估空气渗漏的潜在来源。需要手术干预。区分硬膜外和硬膜内PR很重要，因为后者是严重的潜在伤害的迹象。必须对整个脊柱进行CT成像以寻找空气的延伸，以及识别伴随的头骨，躯干或脊柱损伤大多数患者无症状且保守治疗，但少数人可能会出现神经系统症状，需要进一步评估和治疗。
