椎弓根螺钉对幼犬腰椎发育的影响  

The effects of pedicle screw insertion on the growth of lumbar vertebra of immature canine

作　　者：王亮[1] 罗卓荆[1] 冯林杰[1] 孟浩[1] 罗莉静[2] 

机构地区：[1]第四军医大学西京医院骨科,西安710032 [2]第四军医大学西京医院放射科,西安710032

出　　处：《中华骨科杂志》2007年第5期355-358,共4页Chinese Journal of Orthopaedics

摘　　要：目的通过动物实验观察椎弓根螺钉置入对腰椎形态发育的影响。方法取16只2月龄幼犬，随机分为三组。A组为空白对照组（3只），自L1-7做后路切开显露，暴露目标椎的椎板部分，仅造成对目标椎椎板的软组织剥离损伤。B组为对照组（5只），暴露目标椎椎板后，将螺钉穿过椎弓根，造成对目标椎椎弓根及神经弓中心软骨的隧道破坏后再将螺钉取出，螺钉不留置。C组为实验组（8只），暴露目标椎椎板后，将螺钉穿过椎弓根，造成对目标椎椎弓根及神经弓中心软骨的隧道破坏后不取出，螺钉留置于目标椎椎弓根内。实验的目标椎设计为L2、L4、L6，目标椎的上下两个相邻椎体的相应测量指标的平均值设计为其自身对照。CT测量术后当日及术后3个月的腰椎形态学指标，通过配对t检验比较各组目标椎在不同时期的形态学指标测量值与其自身对照值的差异情况，从而判断椎弓根螺钉的置入对脊椎形态发育的影响效果。结果C组目标椎的椎管面积、横径、纵径、椎弓根长度与相邻脊椎平均值比较差异有统计学意义（P〈0．05），而A组、B组与相邻脊椎平均值比较差异无统计学意义（P〉0．05）。各组椎体横径、纵径、高度与相邻脊椎平均值比较差异无统计学意义（P〉0．05）。结论椎弓根螺钉固定可影响幼犬腰椎椎管及椎弓的发育，可能导致医原性椎管狭窄而对于椎体发育无明确影响。仅破坏神经弓中心软骨联合而不留置螺钉对腰椎发育无明显的影响。Objective To examine the influence of the pedicle screw insertion through the neurocentral cartilage （NCC） on the growth of lumber vertebra in an animal model. Methods Sixteen dogs （about 2 months old） were randomly assigned into 3 groups. In group A （3 dogs）, posterior muscles at the surgery site（L1-7） were dissected through a posterior midline incision, and the tip of the transverse process root of the L2, L4 and L6 was exposed, but the pedicles were not drilled; in group B （5 dogs）, posterior muscles were dissected by the same way, and pedicles were drilled through the NCC by screws, but the screws were taken away after drilling; in group C （8 dogs）, posterior muscles were dissected by the same way, and the screws were placed in the pedicles through the NCC. Vertebras L2, L4, L6 were studied, and the average of the adjacent two vertebras being as control. Spiral computerized tomography （CT） was used to measure the morphologic parameters of studied vertebras and their control vertebras on the first day and 3 months postoperatively. Paired t-tests were performed to evaluate the effect of pedicle screws insertion. Results In group C, spine canal areas, spine canal transverse dimensions, spine canal anterior-posterior dimensions and pedicle lengths of studied vertebras were significantly smaller than the control vertebras （P 〉0.05）. Comparing to controls, the studied lumbar spine showed approximately 6.38% narrowing of spine canal areas, 2.71% shortening of canal transverse dimensions, 5.70% shortening of canal anterior-posterior dimensions, and 5.36% shortening of pedicle lengths over the control vertebras. There were no significant differences of the morphologic parameters between the studied and control vertebras in groups A and B （P 〉0.05）. And in all the groups, there were no significant variation in vertebral body transverse dimensions, vertebral body anterior-posterior dimensions and vertebral body heights（P 〉0.05）. Conclusion These findings suggest that pedicle

关 键 词：腰椎 骨螺丝 骨发育 狗 

分 类 号：R686[医药卫生—骨科学]