骶骨螺钉固定骶髂关节钉道参数的变异性  

Variability of parameters of sacroiliac joint screw path

作　　者：乔国勇[1] 张艳丽[1] 田再杰[1] 孙彦平[2] 陈欣志[1] 姚章喜[1] 扈文海[3] 

机构地区：[1]河北工程大学附属医院骨二科,河北省邯郸市056029 [2]河北省第七人民医院,河北省定州市073000 [3]河北医科大学第三医院骨科,河北省石家庄市050000

出　　处：《中国组织工程研究与临床康复》2008年第52期10223-10226,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：邯郸市科学技术研究与发展计划项目(0823108064)~~

摘　　要：背景:正确地选择进针点、进针方向和骶髂螺钉长度,以及对S1椎弓根形状和骶髂关节毗邻结构解剖的了解成为骶髂关节螺钉置入成败的关键。目的:通过对成人骨盆后环的CT测量,为临床用骶髂螺钉固定骶髂关节提供形态学依据,并探讨钉道参数的变异性相关因素。设计、时间及地点:测量实验,于2008-01/10在河北工程大学CT中心完成。对象:选择100名健康成人,男女各50人,年龄23～56岁,平均32岁,无骶髂关节疾患。方法:用CT对100名健康成人骨盆进行扫描成像,测量S1椎弓根宽、高;S1到髂骨翼的投影点中心(即进针点)至相应椎体对侧前皮质距离,至相应椎弓根中心的距离;进针点与坐骨切迹和髂后上、下棘的距离;S1的轴线(即进针方向)与矢状面和冠状面所成的角度,并记录受检者的性别、身高、体质量。分别对不同性别、左右侧别的钉道长度、进针方向进行显著性检验;以协方差分析方法分析性别、身高、体质量等因素的主效应和交互效应;并以泊松相关分析研究各因素的相关性。主要观察指标:骶髂关节螺钉参数的数值。结果:100名受试者均进入结果分析。①S1椎弓根宽平均(25.8±2.5)mm,高平均(21.2±2.7)mm;进针点至对侧前皮质的距离为(84.5±4.56)mm;进针方向与冠状面的夹角为(25.9±6.5)°,与矢状面夹角为(22.2±5.6)°;进针点与髂后上棘的距离平均(38.5±4.3)mm,与髂后下棘的距离(39.2±6.7)mm;与坐骨大切迹的距离(43.9±7.6)mm。②以协方差分析方法分析性别、体质量、身高各因素对钉道长度、椎弓根宽度的主效应和交互效应,在消除体质量及身高因素的影响后,性别对钉道长度及椎弓根宽度的影响无显著性意义(P>0.05)。左、右侧别相比,钉道长度、进针角度及椎弓根宽度差异无显著性意义(P>0.05)。泊松相关分析显示身高、体质量与椎弓根宽度及钉道长度呈显著正相关,而进针角度与后�BACKGROUND： The entry point and direction of screw, iliosacral screw length, Sl pedicle screw shape and iliosacral joint adjacent structure understandings are key factors for successful iliosacral screw fixation. OBJECTIVE： By studying the adult pelvic posterior ring CT measurement of the parameters of screw fixation of the iliosacral joint to provide related morphological data for the application of iliosacral screw fixation in iliosacral, and to explore the variability of the parameters. DESIGN, TIME AND SETTING： Measurement experiment was performed at the CT center of Hebei University of Engineering from January to October 2008. PARTICIPANTS： 100 healthy adults, 50 males and 50 females, aged 32 years （range 23-56 years） with no iliosacral joint diseases. METHODS： Pelvis of 100 healthy adults were scanned by spiral CT to measure the width and height of the S1 pedicle, the distance from the entry point （center from S1 to iliac ala projection） to contrary anterior cortex of S1, the distance from the entry point to the posterior superior iliac spine, to the posterior inferior iliac spine, and to the greater sciatic notch. The direction of the centre axis of the S1 pedicle, the gender, age, height and body mass were recorded at the same time. The differences in gender and entry path of left and right sides were analyzed. The main effect and interaction of gender, height and body mass were analyzed by analysis of covariance, and correlation among factors was analyzed by Poisson＇s analysis. MAIN OUTCOME MEASURES： Parameters of iliosacral screw. RESULTS： 100 subjects were all include in the final analysis. The mean width and height of the S1 pedicle was （25.8±2.5） mm and （21.2±2.7） mm; the distance from entry point to contrary anterior cortex of S1 vertebral body was （84.5±4.56） mm; the direction of screw was （25.9±6.5） ° to the coronal plane and （22.2_＋5.6） ° to the horizontal plane. The mean distance from entry point was （38.5±4.3） rnm anterior to posterior su

关 键 词：骶髂关节 螺钉 参数 变异性 

分 类 号：R318[医药卫生—生物医学工程]