摘要
目的 分析安全置入胸椎椎弓根钉相关的椎弓根解剖形态特点,研究在探设成人胸椎椎弓根钉通道过程中需要重点探查的区域。方法 使用CT三维重建图像对60位正常发育的成人胸椎椎体和15例胸椎椎弓根钉穿出椎弓根内侧壁的胸椎手术患者进行测量。测量参数包括：临界距离,安全距离,椎弓根钉通道长度,椎弓根宽度,椎弓根横向角,穿出距离。危险区域定义为安全距离和临界距离之差。结果 成人不同节段胸椎的临界距离为8.69~10.53 mm,安全距离为14.53~16.16 mm,危险区域为5.10~6.41 mm。临界距离、安全距离与危险区域相对恒定。椎弓根钉通道长度为31.21~45.01 mm,椎弓根宽度为4.03~8.29 mm。椎弓根横向角从T1的27.68°逐渐减少到T12的7.82°。15枚穿出椎板腹侧皮质或者椎弓根内侧皮质的椎弓根钉的穿出距离为（12.68±1.12）mm,所有的穿出距离均介于临界距离和安全距离之间。结论正确认识成人胸椎的临界距离、安全距离和危险区域有助于安全置入胸椎椎弓根钉。
Objective To analyze the morphologic characteristics of thoracic pedicle with regard to safe thoracic pedicle screw placement in adults and make clear the area where should be checked in preparation of the channel for pedicle screw. Methods Sixty adults were included in this study. Reconstructed CT axial images at each thoracic vertebra were used to measure： the shortest distance from an entry point to the ventral cortex of the lamina （critical distance）, the distance from the entry point to the tangent of the spinal canal at the medial wall of the pedicle （safe distance）, pedicle screw length, pedicle width, pedicle transverse angle, the distance from the entry point to the medial wall breach site （breach distance） in fifteen thoracic vertebra in which the pedicle screw violate the spinal canal more than 2 mm. The dangerous area was defined as the distance between the critical distance and the safe distance. Results The critical distance ranged from 8.69 mm to 10.53 mm in different thoracic levels. The safe distance ranged from 14.53 mm to 16.16 mm. The dangerous area ranged from 5.10 mm to 6.41 mm. The critical distance, safe distance and dangerous area were relatively constant. The pedicle screw length ranged from 31.21 mm to 45.01 mm, and pedicle width ranged from 4.03 mm to 8.29 mm. Pedicle transverse angle decreased gradually from T,（27.68°） to T12（7.82°）. The mean breach distance was （12.68±1.12）mm, all breach distance was between critical distance and safe distance. Conclusion It is helpful to be well informed of the critical distance, safe distance and dangerous area of adult thoracic vertebrae in safe pedicle screw placement.
出处
《中国骨与关节损伤杂志》
2016年第1期1-5,共5页
Chinese Journal of Bone and Joint Injury
基金
国家自然科学基金青年科学基金项目(81201433)
关键词
胸椎
成人
椎弓根钉
解剖形态
CT三维重建
Thoracic vertebrae
Adult
Pedicle screw
Morphology
Computed tomography
