椎弓根外入路行椎体成形术的应用解剖学研究  

Anatomic study and its significance of extrapedicular percutaneous vertebroplasty in the thoracic and lumbar spine

作　　者：王延涛 安丰敏 徐辉 郝延科[2] 

机构地区：[1]烟台海港医院骨科,山东264000 [2]山东中医药大学附属医院骨科

出　　处：《交通医学》2013年第5期465-467,共3页Medical Journal of Communications

摘　　要：目的:探讨胸腰椎椎弓根外入路行椎体成形术的路径,并对其进行解剖学研究,为胸椎后路行椎体成形提供更为安全可靠的方式,以避免胸腰椎手术的危险及并发症。方法:行64排螺旋CT检查100例患者三维重建CT的胸腰椎数据进行放射解剖学研究,测量通过椎弓根中心线入路,人字嵴进针点入路,改良椎弓根外侧入路的角度。同时测量后两者在椎弓根水平距离椎管的最窄距离及最宽距离。对测量数据进行统计学分析并比较3种入路各参数的差异。结果:3种入路角度组间进行比较,差异具有统计学意义(P<0.01),人字嵴进针点与改良椎弓根外侧进针点到达椎管最窄距离比较,差异具有统计学意义(P<0.01)。结论:胸腰椎椎弓根外入路行椎体成形的手术路径,具有理论上的生物力学优越性,是胸腰椎后路椎体成形的一种良好选择。Objective：To investigate the operational approach to Extrapedicular percutaneous vertebroplasty in the thoracic and lumbar spine and make an anatomic study so as to offer safer and more reliable operational approaches to per-cutaneous vertebroplasty and avoid dangerous complications of thoracic transpedicular operations. Methods：A radiological anatomical study was conducted on the thoracolumbar data obtained from the 64-slice spiral CT examination of 100 pa-tients with three-dimensional reconstruction of CT in our hospital radiology department to measure the three approaches of data, which were statistically analyzed. Results：The three approach groups were compared, and the difference was statisti-cally significant （P〈0.01）. In addition, the narrowest distance from the outside of the traditional needle points and improved pedicle needle point to the spine was compared, and the difference was statistically significant（P〈0.01）. Conclusions：Com-pared with the traditional approach, the vertebroplasty surgical path through the outside thoracolumbar pedicle point is safe, reliable, simple and of practical advantages and theoretical biomechanics superiority, and serves as a good choice for poste-rior thoracic and lumbar vertebroplasty.

关 键 词：脊神经根损伤 椎体成形术 根外入路 64排螺旋CT检查 三维重建 

分 类 号：R687.3[医药卫生—骨科学]