胸椎椎弓根-肋骨单元与椎弓根的CT测量  

Morpho-metrological study of thoracical verterbral pedicle rib unit and thoracical pedicle on CT scans

作　　者：谢陶敢 陈其昕[2] 李方才[2] 郦志文 方杰 

机构地区：[1]浙江省诸暨市人民医院骨科,311800 [2]浙江大学附属第二医院骨科,杭州市310009

出　　处：《中国脊柱脊髓杂志》2008年第9期665-668,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:比较经胸椎椎弓根-肋骨单元(pedicle rib unit,PRU)置钉与传统经椎弓根置钉技术的相关径线,为临床应用提供依据。方法:对30例患者脊柱T1～T10节段进行薄层CT扫描,层厚为1mm,选择有完整PRU结构的CT横断面图像进行以下指标测量:(1)PRU宽度(PRU-W),椎弓根宽度(PW);(2)PRU钉道长度(PRU-L),椎弓根钉道长度(PL);(3)PRU中轴与矢状面夹角(PRU-A),椎弓根中轴与矢状面夹角(PA);(4)经PRU置钉的安全角度范围(△A)。结果:PRU-W和PW均以T5最小,以T1为最大,由T1至T5逐渐减小,由T5至T10逐渐增大。PRU-L和PL以T1为最小,以T10为最大,由T1至T10逐渐增大。PRU-A和PA以T1为最大,以T10最小,由T1至T10逐渐缩小。PRU-L与PL、PRU-W与PW间均有显著性差异(P<0.01)。PRU-W、PRU-L在男女之间差异亦有统计学意义(P<0.01)。PRU置钉的安全角度范围△A为20°～30°。结论:胸椎PRU的横径、钉道长度均较同节段的椎弓根大,经PRU可置入更粗更长的螺钉,有更大的内倾角,安全置钉角度范围也较大。Objective：To investigate the differences between two type of pedicle screw insertion technique in thoracic vertebrae,one is going through the pedicle rib unit （PRU）, the other is going through the pedicle as the traditional method.Method：30 adult patients were accepted thin slice CT scan,with the thickness lmm. Images with integrated pedicle rib unit anatomic structure were measured to get the indexes as below： （1） pedicle rib unit width（PRU-W）,pedicle width（PW）.（2）insertion length of pedicle rib unit screw（PRU-L）,insertion length of pedicle screw （PL）.（3）the angle produced by the intersection of central pedicle rib unit axis and sagittal axis（PRU-A）,and the angle produced by the intersection of central pedicle axis and sagittal axis （PA）.（4）the angle extent for safe screw insertion via PRU（AA）.Result：Both PRU-W and PW had the minimum degree in T5 and the maximum degree in T1.The degree decreased from T1 to T5 and increased from T5 to T10.Both PRU-L and PL had the minimum degree in T1 and the maximum degree in T10,presenting an increasing tendency from T1 to T10.Both PRU-A and PA had the maximum degree in T1 and the minimum in T10,presenting a decreasing tendency from T1 to T10.There was statistically significant difference Between PRU-L and PL （P〈0.01）,and the significant difference also presented when PRU-W and PW were compared （P〈0.01）.There were significant differences when PRU-W and PRU-L were statistically studied for different gender（P〈0.01）.The safe angle for screws insertion（AA） was 20°-30°.Conclusion：The width and the length for pedicle screw accommodation in thoracical pedicle rib unit were greater than those in the pedicle, so the thicker and longer screws could be inserted via PRU,meanwhile the possibility of safe screw insertion was elevated.It is necessary of a greater inward angle for screw insertion via PRU ,yet the safer extent of screw insertion was present.

关 键 词：胸椎 椎弓根 椎弓根-肋骨单元 测量 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]