螺旋CT测量在胸腰段椎弓根螺钉置入术中的应用  

Application of spiral CT measurement during the pedicle vertebral arch fixed operation for thoracolumbar spine

作　　者：薛明[1] 姜永宏[1] 刘正华[1] 段竹莲[1] 

机构地区：[1]西安市红十字会医院影像科,陕西西安710054

出　　处：《实用放射学杂志》2011年第10期1541-1543,1547,共4页Journal of Practical Radiology

摘　　要：目的评估CT测量胸腰段椎弓根螺钉置入术中的应用价值。方法测量22例胸腰段（T11～L2：）椎弓根理想螺钉的长度、进钉间距、最小横径、外偏角，观察椎弓根后缘中点与相应横突根部和关节突的下缘的关系。结果T11～L12理想椎弓根螺钉的长度分别为（41．43±4．04）mm、（42．28±4．90）mm、（49．52±4．98）mm、（50．744-4．67）mm；直径分别为（7．03±1．41）mm、（7．1±1．47）mm、（6．12±1．62）mm、（6．31±1．34）mm；进钉间距分别为（30．10±2．44）mm、（31．5±2．60）mm、（35．8±3．00）mm、（37．15±3．16）mm；外偏角分别为4．40°±2．23°、4．44°±1．65°、10．02°±2．30°、10．48°±2．60°。T11椎弓根拟进钉点位于横突根部上缘与关节突中垂线的交点处，T12位于横突根部中上1／3，关节突中垂线偏外处的交点，L1,2位于横突根部中点，关节突外侧缘。结论进行胸腰段椎弓根螺钉固定术时应根据不同节段椎弓根形态特点，选择相应的螺钉直径、长度、进钉部位及方向。Objective To evaluate the value of CT measurement during the operation of pedicle screw insertion for thoracolumbar spine. Methods 22 cases underwent operations of pedicle screw insertion for thoracolumbar spine. The length, width, distance between bilateral entrance points and the pedicle transverse angle were measured by CT,and the relationship between the central point, the base of transverese process and the inferior margins of joint facet were observed. Results The ideal length of the thoracolumbar pedicle screw from Tn to L2 were （41.43±4.04）mm, （42. 28±4. 90）mm, （49. 52±4. 98）mm and （50. 74±4.67）mm;the ideal width were （ 7.03± 1.41 ） mm, （ 7. 1 ± 1.47 ） mm, （ 6. 12 ± 1.62 ） mm and （ 6.31 ± 1.34 ） mm ; the distance between bilateral entrance points were （30.10±2.44）mm, （31.5±2.60）mm, （35.8±3.00）mm and （37. 15±3. 16）mm;the pedicle transverse angle were 4.40±2.23°,4.44±1.65°,10.02±2.30° and 10.48±2.6°,respectively. The entry points for Tu were at the upper edge of transverse process and the middle vertical line of the joint protrusion, for T12 were at the upper third and the outside of middle vertical line of the joint protrusion, for L11 and L2 were at the middle of the base of transverse and the external side fringe of the joint facet. Conclusion The success of thoracolumbar transpedicular fixtion needs to have the reasonable selection of the pediele screws based on CT measured and according to the morphologic features in different segmental pedicles at tboracolumbar spine.

关 键 词：脊柱 椎弓根 螺钉 体层摄影术 x线计算机 

分 类 号：R322.71[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]