上胸椎后路椎板螺钉固定的可行性研究  

A feasibility study of upper thoracic vertebral plate screw fixation through posterior approach

作　　者：钟熙强 何少奇[1] 董伊隆[1] 刘良乐[1] 黄益奖[1] 戴鸣海[1] 汤呈宣[1] 

机构地区：[1]温州医科大学附属第三医院,浙江瑞安325200

出　　处：《中医正骨》2016年第1期1-5,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：浙江省瑞安市科学技术局社会发展科学研究项目(201102051)

摘　　要：目的：了解国人上胸椎椎板的解剖学参数,探讨对国人进行上胸椎后路椎板螺钉固定的可行性。方法：选择40具国人成人尸体T1~T4标本,用游标卡尺和量角器测量与上胸椎椎板螺钉进钉技术相关的解剖参数,包括椎板上、中、下部分的厚度和椎板高度、椎板钉道长度、椎板轴线与矢状面的夹角。结果：20具成人女性尸体T4椎板中部分厚度、T1~T4椎板轴线与矢状面轴线的夹角与男性比较,差异均无统计学意义[（5.94±0.13）mm,（6.00±0.22）mm,t=1.609,P=0.112;46.00°±1.10°,46.50°±1.10°,t=1.955,P=0.054;46.30°±0.80°,46.60°±1.10°,t=1.383,P=0.171;45.40°±1.40°,45.30°±1.40°,t=0.404,P=0.688;45.20°±1.40°,45.30°±1.40°,t=0.410,P=0.683]。成人女性尸体T1~T3椎板中部分厚度小于男性[（5.86±0.10）mm,（5.93±0.18）mm,t=2.083,P=0.040;（5.88±0.11）mm,（5.97±0.20）mm,t=2.581,P=0.012;（5.90±0.09）mm,（6.00±0.19）mm,t=2.885,P=0.006];T1~T4椎板上部分厚度、椎板下部分厚度、椎板高度、椎板钉道长度均小于男性[椎板上部分厚度：（5.39±0.12）mm,（5.51±0.13）mm,t=4.202,P=0.000;（5.43±0.09）mm,（5.52±0.11）mm,t=4.184,P=0.000;（5.43±0.10）mm,（5.53±0.10）mm,t=4.279,P=0.000;（5.41±0.08）mm,（5.53±0.07）mm,t=7.557,P=0.000;椎板下部分厚度：（5.43±0.12）mm,（5.55±0.12）mm,t=4.513,P=0.000;（5.43±0.07）mm,（5.57±0.10）mm,t=7.068,P=0.000;（5.44±0.08）mm,（5.57±0.11）mm,t=6.182,P=0.000;（5.44±0.07）mm,（5.58±0.09）mm,t=7.353,P=0.000;椎板高度：（16.86±0.50）mm,（18.64±0.71）mm,t=13.028,P=0.000;（16.89±0.62）mm,（19.22±0.76）mm,t=15.150,P=0.000;（17.22±0.52）mm,（20.09±0.92）mm,t=17.179,P=0.000;（17.45±0.59）mm,（21.10±0.95）mm,t=14.976,P=0.000;椎板钉道长度：（29.23±1.24）mm,（31.43±2.01）mm,t=5.898,P=0.000;（29.77±1.48）mm,（31.29±2.44）mm,t=3.358,P=0.000;（29.58±1.50）mm,（30.68±2.25）mm,t=2.590,P=0.000;（29.94±1.48）mm,（30.69±2.05）Objective： To study the anatomical parameters of upper thoracic vertebral plate of Chinese adults and explore the feasibility of upper thoracic vertebral plate screw fixation through posterior approach in Chinese adults. Methods：The cadaveric T1 -4 specimens of 40 Chinese adults were selected and the anatomical parameters that related to the upper thoracic vertebral plate screw fixation technique were measured by using vernier caliper and conimeter. The anatomical parameters included the thickness of upper, middle and lower part of vertebral plate, the height of vertebral plate, the screw path length and the included angle between vertebral plate axis and sagittal plane. Results： There was no statistical difference in the thickness of the middle part of T4 vertebral plate and the included angle between T1 - 4 vertebral plate axis and sagittal plane axis between 20 females and 20 males （ 5.94 ＋/- 0.13 vs 6.00 ＋/- 0.22 mm, t = 1. 609, P = 0.112 ; 46.00 ＋/- I. 10 vs 46.50 ＋/- 1.10 degrees, t = 1. 955, P = 0. 054 ;46.30 ＋/- 0.80 vs 46.60 ＋/- 1.10 degrees, t = 1. 383, P = 0. 171 ; 45.40 ＋/- 1.40 vs 45.30 ＋/- 1.40 degrees, t = 0. 404, P = 0. 688 ;45.20 ＋/- 1.40 vs 45.30 ＋/- 1.40 degrees, t = 0.410, P = 0. 683 ）. The thickness of the middle part of T1 -3 vertebral plate were less in adult female cadavers compared to adult male cadavers（ 5.86 ＋/-0.10 vs 5.93 ＋/- 0.18 mm, t = 2. 083, P = 0. 040 ; 5.88 ＋/- 0.1 l vs 5.97 ＋/- 0.20 mm, t = 2. 581, P = 0. 012 ; 5.90 ＋/- 0.09 vs 6.00 ＋/- 0.19 mm, t = 2. 885, P = 0. 006）. Such parameters of T1 -4 were less in adult female cadavers compared to adult female cadavers as thickness of upper part of vertebral plate （ 5.39 ＋/- 0.12 vs 5.51 ＋//- 0.13 mm, t = 4. 202, P = 0. 000 ;5.43 ＋/- 0.09 vs 5.52 ＋/- 0.11 mm, t = 4. 184,P =0.000;5.43 ＋/-0. 10 vs 5.53 ＋/-0. 10 mm,t =4. 279,P =0. 000;5.41 ＋/-0.08 vs 5.53 ＋/-0.07 mm,t = 7. 557,P =O. （X）O） ,thickness of lower pall of vertebral plate（ 5.43 ＋/-0. 12 vs 5.55 ＋/-0.12

关 键 词：胸椎 椎板 内固定器 解剖学 可行性研究 

分 类 号：R687.3[医药卫生—骨科学]