成人髂骨钉钉道的影像学研究  

Radiographic study of adult iliac screw passage

作　　者：郑召民[1] 陈辉[1] 吕游[1] 

机构地区：[1]中山大学附属第一医院脊柱外科,广州510080

出　　处：《中华骨科杂志》2007年第8期586-589,共4页Chinese Journal of Orthopaedics

摘　　要：目的对中国成人髂后上棘至髂前下棘髂骨锚固通道各参数进行影像学测量，探讨髂骨钉置入的可行性与安全性。方法应用多层螺旋CT对60名中国成人进行髂骨三维重建，在斜侧位图像上测量双侧髂后上棘至髂前下棘连线全长及此连线与坐骨切迹上顶点的距离，在沿该连线截面图像上测量双侧钉道通路中髂骨两个狭窄点松质骨与皮质骨的厚度、髂后上棘至第二狭窄点的长度等影像学参数。结果参数均值的95％置信区间：髂后上棘至髂前下棘全长为（140．6±1．1）mm，髂后上棘咬除深度男性为（16．9±0．6）mm、女性为（15．9±0．8）mm，过第二狭窄点长度男性为（67．1±0．6）mm、女性为（70．1±1．4）mm，坐骨切迹上顶点到髂后上棘-髂前下棘连线距离为（18．3±0．8）mm，第一狭窄点松质骨厚度男性为（11．0±0．7）mm、女性为（9．0±0．8）mm，皮质骨厚度男性为（17．3±0．6）mm、女性为（15．7±0．7）mm，第二狭窄点松质骨厚度男性为（11．8±0．7）mm、女性为（8．1±0．7）mm，皮质骨厚度男性为（22．7±0.3）mm、女性为（19．1±0．8）mm。各参数变异度较大，且除髂后上棘至髂前下棘全长及坐骨切迹到该通道高度外，其余各参数男女间差异均有统计学意义。结论成人髂骨由髂后上棘至髂前下棘存在一个直线骨性钉道通路，且该钉道通路中有两个狭窄点，对髂骨钉起锚固作用，通过两个狭窄点的髂骨钉可保证进钉安全性。Objective To study the feasibility and safety of the iliac screw placement, by radiographic measurements of Chinese adult iliac screw passage between posterior superior iliac spine （PSIS） and anterior inferior iliac spine （AIIS）. Methods Reconstruct 60 Chinese ilia by multilayer helico-CT. The length of the line between PSIS and AIIS, and the distance between the line and greater sciatic notch were measured bilaterally on the lateral view, and the thickness of the cancellous and cortical bone at the two most narrow points alone the iliac screw passage bilaterally on the axial view. Results The length of the line between PSIS and AIIS was （140.6±1.1） mm, the cortical bone should be resected for recessing the intrailiac posts-sacral rod connection is （16.9±0.6） mm at male and （15.9±0.8） mm at female, and the distance between the line and greater sciatic notch was （18.3±0.8） mm, the length of the line between PSIS and the second most narrow point was （67.1±0.6） mm at male and （70.1±1.4） mm at female. The thickness of the cancellous bone was （11.0±0.7） mm at male and （9.0±0.8） mm at female at the first most narrow point, while the thickness of the cortical bone was （17.3±0.6） mm at male and （15.7±0.7） mm at female. The thickness of the cancellous bone was （11.8±0.7） mm at male and （8.1±0.7） mm at female at the second most narrow point, while the thickness of the cortical bone was （22.7±0.3） mm at male and （19.1±0.8） mm at female. From the statistic results, great variances were found in all parameters, and there were significant differences between the male and female group in all parameters except the height from sciatic to the passage and the length between PSIS and AIIS. Conclusion There is a straight pathway in adult ilium from PSIS to AIIS. There are two most narrow points alone the pathway, which could anchor the iliac screw. The iliac screw passage could meet the sufficient demand of fixation strength with safety.

关 键 词：髂骨 骨螺丝 摄影测量术 

分 类 号：R686[医药卫生—骨科学]