CT影像测量新疆汉族与维吾尔族男性胸腰段椎弓根的应用解剖特点  

Thoracolumbar pedicle anatomy in Han and Uygur male population in Xinjiang Uygur Autonomous Region: a computed tomography-based morphometric study

作　　者：杨晓凯[1] 刘帅[1] 李磊[1] 黄卫民[1] 张玉坤[1] 毕金坤 周纲[1] 

机构地区：[1]新疆医科大学第六附属医院脊柱外科二病区,新疆维吾尔自治区乌鲁木齐市830002

出　　处：《中国组织工程研究》2017年第15期2400-2405,共6页Chinese Journal of Tissue Engineering Research

基　　金：新疆维吾尔自治区自然科学基金(2016D01C221)~~

摘　　要：背景:胸腰段(T11-L2)由于其特殊的解剖结构与生物力学特征而容易发生损伤,因此术前充分的了解椎弓根形态及术中寻找有形的、恒定的、且顺应椎弓根轴线的进钉点标志对安全置入椎弓根钉极为重要。目的:CT扫描并测量汉族与维吾尔族男性胸腰段椎弓根应用解剖的相关参数,为临床应用椎弓根螺钉内固定提供应用解剖学资料。方法:用CT对120例成年男性受检者(汉族60例,维吾尔族60例)的胸腰段(T10-L3)椎体进行扫描,扫描后的图像行三维重建,在骨窗窗位下使用浏览器中角度及长度测量工具测量并记录横断面椎弓根宽度(TPW),椎弓根轴线长度(PAL),椎弓根横断面角(TPA)和椎弓根矢状面角(SPA)。同时记录受检者的年龄、身高。以上数据运用SPSS 13.0软件进行统计学处理。结果与结论:(1)汉族组在T12和L1节段的横断面椎弓根宽度均值大于维吾尔族;(2)汉族组在T12和L2节段的椎弓根横断面角均值大于维吾尔族;(3)汉族组在T11和L1节段的椎弓根轴线长度和椎弓根矢状面角均值大于维吾尔族,差异有显著性意义(P<0.05)。(4)实验所测量汉族与维吾尔族男性胸腰段弓根各径线的数据部分有差异,任何椎弓根形态测量所得的均数值只能为安全置入椎弓根螺钉提供一个参考。在椎弓根螺钉置入术前行CT测量相关参数,并制定个体化置钉方案,能有效降低因误置而导致的不必要的术后并发症发生率。BACKGROUND： Thoracolumbar segments （T11-L2） prone to damage due to its special anatomical and biomechanical characteristics. Therefore, fully understanding the shape of pedicle of vertebral arch and finding the visible, constant, and the point of insertion of the pedicle axis is very important to the safety of pedicle screw placement.OBJECTIVE： To measure the surgically relevant parameters of thoracolumbar pedicles between Han and Uygur males using computed tomography （CT） scan to provide some anatomic reference data for pedicle screw fixation.METHODS： The vertebral bodies and pedicles of adult males were scanned （60 cases of Han people and 60 cases of Uygur people） from T10-L3 with CT. The parameters were processed by three-dimensional reconstruction. Transverse pedicle width, pedicle axis length, transverse pedicle angle, and sagittal pedicle angle were measured by using length and angle measurement tool of browser in bone-window CT images. The age and stature information were recorded. All the data above were processed by SPSS 13.0 software.RESULTS AND CONCLUSION： （1） The mean transverse pedicle width of T12 and L1 in Han was bigger than that in the Uygur. （2） The mean transverse pedicle angle of T12 and L2 in Han was bigger than that in the Uygur. （3） The mean pedicle axis length and sagittal pedicle angle of T11 and L1 in Han were bigger than that in the Uygur （P 〈 0.05）. （4） There were some differences among some parameters of the thoracolumbar pedicles between the Han and Uygur people.Data from any study only can be used as a guide for pedicle screw fixation. Preoperative CT evaluation may provide an individualized strategy to reduce the incidence of postoperative complications caused by misplacement.

关 键 词：胸腰段 椎弓根 解剖学 汉族维吾尔族 CT 骨科植入物 脊柱植入物 应用解剖 汉族 维吾尔族 新疆维吾尔自治区自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]