腰椎棘突及其间隙的解剖学测量  

Anatomical measurement of the lumbar spinous process and the gap

作　　者：刘瑞[1] 张元智[1] 徐林[2] 李志军[1] 俞兴[2] 

机构地区：[1]内蒙古医学院附属医院骨科,内蒙古呼和浩特010050 [2]北京中医药大学东直门医院骨科中心,北京100700

出　　处：《生物骨科材料与临床研究》2012年第2期5-9,I0005,共6页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：内蒙古自治区自然科学基金项目(2010MS1106);内蒙古自治区高等学校科学研究课题(NJ10132)

摘　　要：目的利用三维重建技术为棘突间撑开的设计、优化、国产化及临床应用提供解剖学依据。方法选取50例志愿者采用连续螺旋CT断层扫描T12~S1,将获得图像导Materialise Mimics10.01软件,采取轮廓和区域增长分割出腰椎骨组织,采用表面遮盖显示法进行三维表面重建,选择去除椎旁组织的最佳三维角度,由同一名研究者选择适合测量的图像进行测量,测量棘突厚度、棘突长度、棘突间距。各解剖结构连续测量3次,取其均值。数据进行正态性检验、检验。结果①棘突厚度：一般每个腰椎的棘突厚度均前部〉后部〉中部,下缘〉中央〉上缘。但L5较特殊,棘突中部和后部的中央厚,上、下缘薄。相邻上位腰椎棘突下缘厚度大于下位腰椎棘突上缘厚度。②棘突长度以L3最大,男性：上缘26.62±2.98mm,中央25.59±2.33mm,下缘22.73±2.40mm;女性：上缘23.76±2.47mm,中央24.49±2.48mm,下缘19.70±2.49mm;男女均以L5最小。③棘突间距：男性以L2∕3最大,向下依次减小,前部〉中部〉后部。前部10.39±2.70mm,中部11.15±2.20mm,后部9.35±2.17 mm。女性以L1∕2最大,向下依次减小,前部〉中部〉后部。前部10.32±2.10mm,中部12.18±2.58mm,后部10.80±2.43mm。男女均以L4∕5最小。结论棘突间距从上向下逐渐减小,前部〉中部〉后部,在矢状面棘突间隙呈前高后矮的楔形。棘突长度以L3最大,L5最小。棘突长度均上缘〉中央〉下缘,相邻上位腰椎棘突下缘长度〈下位腰椎棘突上缘长度。棘突厚度前部〉后部〉中部,且下缘〉中央〉上缘。相邻上位腰椎棘突下缘厚度〉下位腰椎棘突上缘厚度。本研究利用三维CT重建技术初步获得了国人腰椎棘突及棘突间隙的解剖学参数,为适合国人特点的腰椎棘突间撑开器的设计和临床应用提供了解剖学数据。Objective To supply anatomical basis for the design,optimize,localize and clinical application of interspinous internal fixation instrument of lumbar vertebrae by the technique of three-dimension﹙3-D﹚reconstruction.Methods 50 volunteers were subjected to CT scanner from T 12 to S 1 level.CT scan images were imported into Materialise Mimics 10.01 software.Bone organization threshold,outline and edge were defined and edited selectively,then measurement tools were used to measure the following parameters of lumbar vertebrae by the same researcher ： the thickness of spinous processes,the height of spinous processes and the distance between 2 adjacent spinous processes.All the data were analyzed with the SPSS l3.0 statistical software for test of normality and t test.Results ①Lumbar spinous thickness ： generally,front partback partmiddle part,inferior border central superior border.But L 5 is more special,middle part and back part of spinous were thicker than superior border and inferior border.Adjacent upper lumbar spinous inferior borderis thicker than down lumbar spinous superior border.② L 3 has the longgest spinous,Male ： superior border 26.62±2.98 mm,central 25.59 ±2.33 mm,inferior border 22.73± 2.40 mm;Female ： superior border 23.76 ± 2.47 mm,central 24.49± 2.48 mm,inferior border 19.70± 2.49 mm;L 5 has the shortest spinous.③ spinous spacing ： in male,L 2∕3 has the biggest space,and minish in turn down,all of them is front partmiddle partback part.Front part 10.39± 2.70 mm,middle part 11.15±2.20 mm,back part 9.35± 2.17 mm.In female ： L 1∕2 has the biggest space,and minish in turn down,all of them is front partmiddle partback part,too.Front part 10.32 ± 2.10 mm,middle part 12.18± 2.58 mm,back part 10.80±2.43 mm.L 4∕5 has the smallest space.Conclusion Spinous decreased gradually from top down,front partmiddle partback part,in Sagittal plane spinous space is wedge-shape.Spinous maximum length by L 3,L 5 is minimum.Spinous lengths ： superior bordercentral inferior border,ad

关 键 词：三维重建 腰椎 棘突间 解剖 

分 类 号：R687.3[医药卫生—骨科学]