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纸质出版:2014
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丁浩洋,汪洋,唐杰,何忠成,柯珍勇.伤椎斜行置钉治疗单纯腰椎压缩性骨折的解剖学研究[J].陆军军医大学学报(原第三军医大学学报),2014,36(18):1957-1960.
Ding Haoyang,Wang Yang,Tang Jie,He Zhongcheng,Ke Zhenyong.Anatomy of oblique pedicle screw placement for treating simple compression fracture of lumbar[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(18):1957-1960.
丁浩洋,汪洋,唐杰,何忠成,柯珍勇.伤椎斜行置钉治疗单纯腰椎压缩性骨折的解剖学研究[J].陆军军医大学学报(原第三军医大学学报),2014,36(18):1957-1960. DOI:
Ding Haoyang,Wang Yang,Tang Jie,He Zhongcheng,Ke Zhenyong.Anatomy of oblique pedicle screw placement for treating simple compression fracture of lumbar[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(18):1957-1960. DOI:
目的 通过对腰椎椎弓根解剖学测量,探讨伤椎斜行置钉的可行性。 方法 分析2011年2月至2013年12月我院52例患者的腰椎CT资料,通过相应纳入指标,筛选26例患者共100个椎弓根三维重建数据,测量在标准进钉点(以椎弓根中点为标准进钉点)进钉突破椎弓根后缘时对应矢状面所成最大夹角及进钉点上下移动后对应矢状面所成最大夹角。 结果 ①以椎弓根中点为进钉点时上下矢状面最大夹角L
1
~L
5
分别为(±18.2°±2.0°)、(±15.2°±2.9°)、(±14.1°±2.9°)、(±15.1°±3.6°)、(±17.4°±3.3°);②进钉点上移:L
1
~L
5
分别为(5.2±0.6)、(4.2±0.6)、(4.2±0.5)、(3.9±0.8)、(4.0±0.8)mm时,相应矢状面最大夹角分别为(33.3°±3.2°)、(28.4°±4.8°)、(26.6°±4.8°)、(28.2°±5.9°)、(31.9°±5.3°);③进钉点下移:L
1
~L
5
分别为(5.2±0.6)、(4.2±0.6)、(4.2±0.5)、(3.9±0.8)、(4.0±0.8)mm时,相应矢状面最大夹角分别为(-33.3°±3.2°)、(-28.4°±4.8°)、(-26.6°±4.8°)、(-28.2°±5.9°)、(-31.9°±5.3°)。 结论 通过测量数据分析得出调整进钉点及矢状面头尾倾角可达到斜行置钉的目的,可用于治疗单纯腰椎压缩骨折。
Objective To discuss the possibility of oblique pedicle screw placement by the anatomic measurement of the lumbar pedicle. Methods The clinical data of lumbar computed tomography of 52 patients from February 2011 to December 2013 in our hospital were accessed. We collected 100 three-dimensional reconstruction data of the lumbar pedicles from 26 of the patients. W
ith these data
we measured the maximum sagittal angle between the screw and the pedicle while the screw broke through the pedicle’s trailing edge at the standard entrance point (with the midpoint of the pedicle as a standard entrance point)
and also measured the sagittal section angle between the screw and the pedicle while the entrance move vertically. Results When using the standard entrance point
the maximum sagittal section angle were: L
1
±18.2°±2.0°
L
2
±15.2°±2.9°
L
3
±14.1°±2.9°
L
4
±15.1°±3.6°
and L
5
±17.4°±3.3°. When moving up the entrance point by L
1
5.2±0.6 mm
L
2
4.2±0.6 mm
L
3
4.2±0.5 mm
L
4
3.9±0.8 mm
and L
5
4.0±0.8 mm
the maximum sagittal section angle were: L
1
33.3°±3.2°
L
2
28.4°±4.8°
L
3
26.6°±4.8°
L
4
28.2°±5.9°
and L
5
31.9°±5.3°
respectively. When moving down the entrance point by L
1
5.2±0.6 mm
L
2
4.2±0.6 mm
L
3
4.2±0.5 mm
L
4
3.9±0.8 mm
and L
5
4.0±0.8 mm
the maximum sagittal section angle were: L
1
-33.3°±3.2°
L
2
-28.4°±4.8°
L
3
-26.6°±4.8°
L
4
-28.2°±5.9°
and L
5
-31.9°±5.3°
respectively. Conclusion Selecting a proper scope of the entrance point with a proper sagittal angle helps place a screw into the uninjured part of the vertebra
which can be used for the treatment of simple compression fracture of lumbar.
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