腰骶移行椎上一节段腰椎的形态学特点及临床意义  

Morphological characteristics of the lumbar segment above the lumbosacral transitional vertebrae and its clinical significance

作　　者：杨立辉[1] 柳伟[1] 王瑞[1] 张继宗[2] 孔晓川[1] 安立琨[1] 杜心如[1] 

机构地区：[1]首都医科大学附属北京朝阳医院骨科,北京100020 [2]中国公安部物证鉴定中心,北京100080

出　　处：《中国临床解剖学杂志》2011年第4期392-395,共4页Chinese Journal of Clinical Anatomy

基　　金：北京市教委资助项目(KM200610025019);首都医科大学基础临床联合资助项目

摘　　要：目的研究腰骶移行椎上一节段腰椎的形态特点,为腰骶移行椎合并腰椎滑脱、不稳症时椎弓根螺钉内固定术提供依据。方法对59例腰骶移行椎上一节段腰椎标本的矢状径、横径,峡部的高度、厚度;椎弓根的纵径、横径;椎板的高度、厚度;脊椎指数及退变情况等进行观测。结果腰骶移行椎上一节段椎体前后径(34.1±2.7)mm,横径(47.5±4.6)mm;峡部高度(12.9±1.6)mm;峡部厚度(9.0±1.2)mm;椎弓根纵径(10.6±2.4)mm,椎弓根横径(14.0±2.4)mm;椎板高度(18.2±2.6)mm,椎板厚度(5.7±1.2)mm。脊椎指数:1:4.35;81.4%(48例)发生椎体增生,未发现峡部裂。结论腰骶移行椎上一节段腰椎椎体各径线及椎弓根横径较正常L4椎体大,可选择直径稍大的椎弓根螺钉;峡部厚度较正常L4增加;峡部不存在发育薄弱和局部缺损。Objective To study morphological characteristics of the lumbar segment above the lumbosacral transitional vertebrae, and provide anatomic basis for the clinical treatment in the spondylolisthesis, lumbar disc herniation and pedicle screw fixation. Methods 59 specimens of dry lumbar segment above the lumbosacral transitional vertebrae were anatomically evaluated. The anteroposterior diameter, the transverse diameter, the thickness and height of the vertebral isthmus, the longitudinal diameter and transverse diameter of the vertebral pedicle, the height and thickness of the vertebral lamina, the spine index, and the degeneration state were measured with the caliper and the protractor in all specimens. Results The anteroposterior diameter and transverse diameter of vertebral isthmus were（ 34.1±2.7 ）mm and（47.5±4.6 ）mm respectively. The height of vertebral isthmus was（ 12.9±1.6 ）mm, and the thickness （9.0±1.2）mm. The longitudinal and transverse diameters of vertebral pedicle were （ 10.6±2.4）mm and （14.0±2.4）mm respectively. The height of the lamina was（ 18.2±2,6）mm, and the thickness （5.7±1.2）mm. The spine index was （1：4.35）. The hyperplasia of upper vertebra appeared in 48 specimens. Spondylolysis was not found in all specimens. Conclusions The vertebral body of lumbar segment above the lumbosacral transitional vertebrae and the transverse diameters of the vertebral pedicle are larger than that of the fourth lumbar vertebrae, which is the support for selecting the larger screws for pedicle fixation. The isthmus thickness of lumbar segment above the lumbosacral transitional vertebrae is larger than that of the fourth lumbar vertebrae,however, congenital developmental defects and weak are not found.

关 键 词：腰椎 腰骶移行椎 上一节段腰椎 第4腰椎 

分 类 号：R323.43[医药卫生—人体解剖和组织胚胎学] R682.13[医药卫生—基础医学]