单侧入路经皮椎体后凸成形术关键参数的影像学测量  

Radiographic measurement of key parameters used in the unilateral transpedicular approach on percutaneous kyphoplasty

作　　者：翟伟峰[1] 贾永伟[1] 王建杰[1] 程黎明[1] 

机构地区：[1]同济大学附属同济医院脊柱外科,上海200065

出　　处：《徐州医学院学报》2015年第4期225-229,共5页Acta Academiae Medicinae Xuzhou

基　　金：上海市卫生局科研项目（2009138）

摘　　要：目的探索基于影像学测量获得单侧入路经皮椎体后凸成形术的关键参数，为临床操作提供参考。方法随机选择我科住院患者的胸椎、腰椎CT片各120例，利用我院影像科PACS系统、Uniweb Server软件，通过模拟单侧入路经皮椎体后凸成形术的最佳穿刺路径，测出T4～L5椎体穿刺路径的内倾角、尾倾角、皮肤入针点旁开棘突的距离。并结合临床实践，验证数据的准确性。结果单侧穿刺途径：T4-T9椎体，内倾角（24．6±4．2）°，尾倾角（19．8±1．8）°，棘突旁开距离（3．5±0.5）cm。T10～L2椎体，内倾角（25．6±4．8）°，尾倾角（18．5±1．6）°，棘突旁开距离（3．8±0．6）cm。L3～L5椎体，内倾角（34．2±7．8）°，尾倾角（17．5±1．9）°，棘突旁开距离（5．9±1．2）cm。结论基于影像学测量获得关键参数，是顺利进行单侧入路经皮椎体后凸成形术的重要依据，根据测量的数据指导临床实践，操作简便、安全，穿刺准确性高，对临床操作有一定的参考价值。Objective To obtain the key parameters required for the unilateral transpedicular approach on percutaneous kyphoplasty through imaging measurement, so as to provide evidence for clinical practice. Methods A total of 120 CT images of thoracic and lumbar vertebrae were randomly collected from patients in our department. Then, using the PACS system and Uniweb Server software, the angles of introvertion and declination, and the distance between the skin entry point and the spinous process from T4 to L5 were measured through imitation of pereutaneous kyphoplasty via the unilateral transpodicular approach. Meanwhile, the accuracy of the measurement was verified on the basis of clinical practice. Results The unilateral transpedicular puncture yielded an introvertion angle of （24.6 ± 4.2 ） for T4 - T9, （ 25.6 ± 4.8 ） for Tto - L2 and （ 34.2 ± 7.8 ） for L3 - L5 and a declination angle of （ 19.8 ± 1.8 ） for T4 - T9, （ 18.5 ± 1.6 ） for T10 -L2 and （17.5 ± 1.9 ） for L3 -L5. The distance between the skin entry point and the spinous process was （3.5 ±0.5） emforT4-T9, （3.8± 0.6） cmforT10-L2and （5.9±1.2） cm for L3-L5. Conclusion The key parameters obtained through radiographic measurement are of importance for percutaneous kyphoplasty via the unilateral transpedieular approach, making the operative procedures convenient, safe and accurate when applied in clinical praetiee.

关 键 词：椎体后凸成形术 单侧入路 CT图像 

分 类 号：R683.2[医药卫生—骨科学]