摘要
目的为腰椎峡部裂横突-棘突间线缆捆扎和椎板螺钉修复重建手术提供所需的解剖学数据,以提高手术的安全性和有效性。方法对31具结构完好的成年人L4、L5标本横突、椎板和峡部等结构进行解剖测量。结果①横突：横突起始部、内1/4点处、中点处宽度及厚度,均为L5〉L4;在同一测量点,L5横突横截面积约为L4的2倍。②椎板：椎板上缘平均厚度,L5为3.21mm,〉L4的2.75mm;而椎板下缘平均厚度,L5为5.71mm,较L4的4.93mm略厚。椎板与棘突根部交界线中点到对侧横突起始部前缘距离,L5平均为45.78mm,明显〉L4的37.89mm。上面观钉道与矢状面的夹角L4、L5节段均在55°-56°,后面观钉道与矢状面的夹角L4〈L5,L4为65°-66°,L5为72°-73°.③峡部：峡部的厚度和高度在L4和L5间差异无显著性。峡部下缘明显厚于上缘。峡部中份厚度为6．5-7mm。结论①L4横突远较L5薄弱，在捆扎线缆时L4横突可承受的应力远〈L5。捆扎点均应在横突起始部附近。②采用椎板螺钉修复峡部裂时，L4应选择较小螺钉，选择钉道宜在峡部居中或靠下位置。③应重视峡部处植骨。
Objective To provide data through anatomical study to facilitate the interspinous-transverse process cable and translaminar screw reparative and reconstructive surgery of spondylolysis. Methods Structures including transverse process, lamina and pars interarticularis in intact vertebrae specimen of L4 and L5 levels from 31 normal adult corpuses were anatomically measured. Results ① Transverse process. The thickness and width of transverse process at the starting point, medial one fourth point and midpoint of Ls level were greater than those of L4 level. At the same measured point, the L5 transverse process had a cross sectional area two times as that of the L4 transverse process.② Lamina： The average thickness of the upper border of L5 lamina was 3.21 mm, which was greater than the 2. 75 mm of L4 lamina. And the average thickness of the inferior border of L5 lamina was 5.71 mm, which was slightly larger than the 4. 93 mm of L4 lamnina. At L5 level, the distance from the midpoint of the boundary of the lamina and the base of pedicle to the starting point of the anterior border of the transverse process on the other side was 45.78 mm, far greater than the 37.89 mm of L4 level. From the superior view, the angle between the screw path and the sagittal plane was about 55° - 56° at both L4 and L5 levels. From the posterior view, the angle between the screw path and the sagittal plane was about 65° -66° at L4 level, and about 72° -73° at L5 level. ③ Pars interarticularis： There was no significant difference in the height and thickness of pars interarticularis between L4 and L5 levels. The inferior border of pars interarticularis was distinctly thicker than the superior border. The thickness of central part of pars interarticularis was about 6. 5 - 7 nun. Conclusions ① The transverse process of L4 is weaker, and less tensile strength can be exerted when binding the cable. ② The screws used for L4 level should be smaller than the ones used for L5 level. The screw path should be through the central or i
出处
《临床骨科杂志》
2007年第3期273-276,共4页
Journal of Clinical Orthopaedics
关键词
腰椎峡部裂
腰椎/解剖学和组织学
lumbar vertebrae spondylolysis
lumbar vertebrae/anatomy ＆ histolgy
