中下胸椎肋凹位置的研究及侧前方置钉数字化模拟  

Anatomic allocation and digital simulation of the costal facet of the middle and lower thoracic vertebra

作　　者：李筱贺[1,2] 李少华[3] 由博[4] 李志军[2] 王星[2] 陈海芳[3] 张业辉[3] 徐达传[1] 

机构地区：[1]南方医科大学临床解剖学研究所,广州510515 [2]内蒙古医学院基础医学院解剖学教研室,呼和浩特010059 [3]广东医学院解剖学教研室,东莞523808 [4]新疆大学机械工程学院,乌鲁木齐830000

出　　处：《中国临床解剖学杂志》2010年第3期251-254,共4页Chinese Journal of Clinical Anatomy

基　　金：广东省科技计划项目(2008B030301030);国家自然科学基金(30660072);内蒙古自然科学基金(2009MS1112)

摘　　要：目的为临床提供中下胸椎侧前方固定以肋凹为参照物的解剖学数据。方法在25～60岁(平均43岁)40例完整的中下胸椎(T4～12)标本中测量肋凹前缘与椎孔前缘间距离(DCFC),椎孔前缘与椎间孔前缘间距离(DCF),肋凹下缘与上终板上缘的距离(DIFSP);对6例T4～12非脊柱疾患CT资料三维重建,模拟置钉并测量其钉道长。结果肋凹前缘与椎孔前缘间距离,在胸椎中下段由正变负;椎孔前缘与椎间孔前缘间距离,在胸椎中下段变化不大,最小值出现在T6,最大值出现在T4。肋凹下缘与上终板上缘的距离由T4到T12逐渐增大,呈直线上升的趋势。随着椎序的增加,置钉点坐标逐渐移向椎体前上方,钉道也逐渐增长。结论随着椎序的增加,肋凹逐渐向后下方移动,其位置有规律可循,可以作为胸椎中下段侧前方置钉的参照点,其钉道长随椎序逐渐增大,可参考本文数据进行置钉点和螺钉长度的选择。Objective To provide anatomic data for lateral and anterior fixation of the middle and lower thoracic vertebra according to the location of costal facet.Methods On 40 intact specimens of the middle and lower thoracic vertebra（（T4～T12）,with the age from 25 to 60,the distances from anterior border of costal facet to anterior border of vertebral foramen（DCFC）,from anterior border of vertebral foramen to anterior border of intervertebral foramina（DCF）,from inferior border of costal facet to superior border of superior terminal plate（DIFSP） were measured respectively.CT data of 6 healthy adults were used to reconstruct and simulate screw canal fixation.Results The DCFC decreased gradually from the middle to lower thoracic vertebra,however,there were no obvious difference for DCF,despite of minimum value of T6,and maximum value of T4.DIFSP gradually increased from T4 to T12.The coordinate of the screw gradually removed to the superior of the lower thoracic vertebra,with the increased length of screw canal.Conclusions The location of costal facet gradually reaches the posterolateral of vertebra from middle to lower thoracic vertebra,which is a valuable reference for determining the site of screw fixation and the length of screw canal.

关 键 词：中下段胸椎 肋凹 侧前方固定 数字解剖学 

分 类 号：R687.32[医药卫生—骨科学]