青少年中上胸椎的影像解剖学特点  

Radiographic anatomy features of teenagers' upper-middle thoracic vertebrae

作　　者：张志峰[1] 史君[2] 魏晶[3] 王星[4] 郑雷刚 霍洪军[1] 李志军[4] 

机构地区：[1]内蒙古医科大学第二附属医院关节科,内蒙古自治区呼和浩特市010030 [2]内蒙古医科大学基础医学院生理教研室,内蒙古自治区呼和浩特市010110 [3]内蒙古医科大学第二附属医院手外科,内蒙古自治区呼和浩特市010030 [4]内蒙古医科大学基础医学院人体解剖教研室,内蒙古自治区呼和浩特市010110 [5]内蒙古自治区中医院骨科

出　　处：《中国组织工程研究》2014年第9期1386-1391,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81260269);内蒙古自治区自然科学基金(2012MS1149);内蒙古医科大学青年创新基金(YKD2013QNCX018)~~

摘　　要：背景:处于发育高峰的青少年和成人骨骼情况存在较大差异,若以成人的标准去置钉青少年群体则有较大危险性。目的:观测青少年中上胸椎影像解剖学特点,为青少年中上胸椎经椎弓根置钉及经椎弓根-肋头单元置钉提供实验依据。方法:将30例无脊柱区病变青少年(13-18周岁)T1-T12节段行CT扫描(0.625-1.25 mm)后,原始数据以DICOM格式导入三维重建软件进行相关指标测量,按不同节段进行统计分析。结果与结论:椎弓根宽和椎弓根-肋头单元宽的总体走势接近,均呈"V"型,最小值位于T4处,并且两者之间相对应椎体的差异有显著性意义(P<0.05);椎弓根钉道长度和椎弓根-肋头单元钉道长度之间其走势基本一致,均呈逐渐递增趋势,最小值为T1,最大值位于T10处,二者之间相对应的椎体间差异均有显著性意义(P<0.05);椎弓根横断面角与椎弓根-肋头单元横断面角的走势相似,T1-T10总体也呈下降趋势,并且与各相应椎骨间差异均有显著性意义(P<0.05);椎弓根矢状面角与椎弓根-肋头单元矢状面角的曲线走势基本相近,均呈波浪型,并且与各相应椎骨间差异均有显著性意义(P<0.05)。提示相同节段的椎弓根-肋头单元可以提供较椎弓根相对安全的置钉钉道。BACKGROUND： The conditions of teenager and adult skeletons have great differences. Thus, it is dangerous to place screw on teenagers using the methods for adults. OBJECTIVE： To observe the anatomical features of teenagers＇ upper-middle thoracic vertebra images, and to provide experimental basis for pedicle nailing and pedicle-rib head unit nailing in teenagers＇ upper-middle thoracic vertebrae. METHODS： We chose 30 teenagers （13 to 18 years old） without spine lesions, and then they were scanned （0.625-1.25 mm） from T1 to T12 segments using CT. The original data were loaded into a three dimensional software in DICOM format for measuring related indicators. At last, we analyzed the data according to different segments. RESULTS AND CONCLUSION： The trend between the width of pedicle and pedicle-head unit was similar,showing a ＂V＂ shape. The minimum of width was located in the T4, and there were significant differences between the corresponding vertebral bodies （P 〈 0.05）. The trend between pedicle nail road length and pedicle-rib head unit nail road length was similar, and the trend between them was gradually increasing. The minimum of length was located in TI, and the maximum of length was located at Tl0, and there were significant differences between the corresponding vertebral bodies （P 〈 0.05）. The trend between the pedicle transverse angle and pedicle rib-head unit transverse angle was similar. The trend from T1 to Tl0 was on a decline, and there were significant differences in corresponding vertebrae （P 〈 0.05）. The trend of curves between pedicle sagittal angle and pedicle rib-head unit sagittal angle was similar, showing a wavy shape, and there were significant differences in corresponding vertebrae （P 〈 0.05）. These results confirmed that the same segmental pedicle rib-head unit can provide a safer nailing place than the pedicle relatively.

关 键 词：植入物 数字化骨科 胸椎 椎弓根 椎弓根-肋头单元 三维重建 影像测量 螺钉植入 青少年 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]