胸椎肋骨横突螺钉技术的CT影像解剖学参数研究  

Costotransverse screw fixation in the thoracic vertebrae: a CT imaging morphometric study

作　　者：沈中海 李耀[2] 王向阳[2] SHEN Zhong-hai;LI Yao;WANG Xiang-yang(Department of Orthopaedics,Second Hospital of Jiaxing,Second Affiliated Hospital of Jiaxing University,Jiaxing 314000,Zhejiang,China;Department of Orthopaedics,Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]嘉兴市第二医院嘉兴学院附属第二医院骨科,嘉兴314000 [2]温州医科大学附属第二医院骨科,温州325000

出　　处：《脊柱外科杂志》2019年第5期345-349,共5页Journal of Spinal Surgery

摘　　要：目的通过影像学测量对胸椎肋骨横突螺钉技术解剖学参数进行分析,为该技术的临床应用提供参考。方法选取100名健康成年志愿者T1~10胸椎肋骨结合区的CT图像,应用PACS软件分别测量每个椎体相应横突模拟进钉点(A点和B点)在横断位上的肋骨横突长(CL)、肋骨横突宽(CW)以及最大内倾角(MIA)和极限外展角(UEA),其中A点为横突背侧肋骨横突关节表面,B点为横突背侧最内侧缘。结果A点CL最大值均位于T6节段,最小值位于T1节段,以T6节段为分界点呈先增大后减小的变化趋势;B点CL较为平稳。A、B点CW最大值均位于T1节段,最小值位于T6节段,以T6节段为分界点呈先减小后增大的变化趋势。A点MIA最大值位于T6节段,最小值位于T1节段,以T6节段为分界点基本表现为先增大后减小的变化趋势;B点MIA较为平稳。A点UEA从T1节段到T10节段逐渐减小,B点UEA则从T1节段到T10节段逐渐增大。结论本研究设计的2个胸椎肋骨横突螺钉进钉点的解剖学参数有不同特点,可为胸椎肋骨横突螺钉固定技术的临床应用提供参考。Objective To explore and analyze the anatomical parameters of costotransverse screw placement in the thoracic vertebrae by CT imaging measurement for providing the relevant references for clinical application of this technique.Methods One hundred healthy adult volunteers were selected by retrospective review without any spinal disorder findings in the T1-10 costoranseverse area on CT.The longest costotransverse length(CL) and widest costotransverse width(CW),maximum inclined angle(MIA) and ultimate extented angle(UEA) on axial CT were measured using PACS software at each segment. The simulative entrance point for screw insertion was placed according to the technique at the clubbed extremity of the transverse process that lies directly dorsal side of center of the costotransverse joint(point A) and at the root of the transverse process(point B).Results The maximum CL of point A was at T6,while the minimum CL was at T1.By a boundary of T6, the CLs increased firstly and then decreased.The CLs of point B were relatively stable.The maximum CWs at point A and B were both at T1,and the minimum CWs at T6.By the boundary of T6,the CWs decreased firstly and then increased.The maximum MIA of point A was at T6,while the minimum MIA was at T1.By the boundary of T6,the MIAs increased firstly and then decreased generally.The MIAs of point B were relatively stable.UEA reduced gradually from T1 to T10 at point A, and increased gradually form T1 to T10 at point B.Conclusion The costotransverse screw entry points designed in the study have corresponding detailed anatomical parameters,which can provide a certain reference for the clinical application of costotransverse screw placement.

关 键 词：胸椎 骨钉 解剖学 放射摄影术 

分 类 号：R681.532[医药卫生—骨科学]