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作 者:李身泰 李明[1] 马维[1] LI Shentai;LI Ming;MA Wei(Department of Osteology,The Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China)
机构地区:[1]河北医科大学第二医院骨科,石家庄市050000
出 处:《河北医药》2021年第12期1788-1791,1796,共5页Hebei Medical Journal
摘 要:目的测量正常国人腰椎椎弓根钉道的各项参数的数值,为腰椎后路手术提供数据参考,为国人内固定物的制造提供数据参考。方法挑选腰椎结构正常的志愿者58例,男30例,女28例;平均年龄(34.47±6.36)岁,平均身高(1.68±0.07)m。应用GE Light Speed 16排CT扫描仪从志愿者头端向远端连续扫描全腰椎,层厚设定为0.625 mm,扫描后数据上传致相关软件后依次测量各个腰椎的椎弓根钉道各项参数数值并进行分析。结果从L1到L5,椎体椎弓根轴线与垂直线成角(A角)、椎弓根轴线与棘突轴线的成角(B角)、椎弓根宽度逐渐增大,差异有统计学意义(P<0.05)。入点至椎体前缘距离逐渐增大,到L4达到最大,L5又减小,差异有统计学意义(P<0.05)。同一椎体左右椎弓根宽度、入钉点至椎体前缘距离差异无统计学意义(P>0.05)。结论本研究数据为临床手术提供了不同椎体应选用特定的直径和长度的螺钉,在水平面上可通过特定的外展角度安全置入,在同一椎体以相同的矢状角度、相反的水平外展角度在左右椎弓根置入相同直径和长度的螺钉的信息。Objective To measure the values of various parameters of the lumbar pedicle screw path of healthy Chinese people,so as to provide data reference for posterior lumbar spine surgery as well as for the manufacture of internal fixation for Chinese people.Methods A total of 58 healthy volunteers with normal lumbar spine structure were selected,including 30 males and 28 females,with an average age of(34.47±6.36)years and an average height of(1.68±0.07)m.The GE Light Speed 16-slice CT scanner was used for continuous scanning of the whole lumbar spine from the volunteer’s head to the distal end,with the thickness set to 0.625 mm.After the scanning,the data were uploaded to the relevant software and the values of various parameters of the lumbar pedicle screw path were measured for analysis.Results The angle between the pedicle axis line of the vertebral body and the vertical line(angle A)from L1 to L5,and the angle between the pedicle axis line and the axis line of spinous process(angle B),and the width of the vertebral pedicle were gradually increased,and the difference was significant(P<0.05).The distance from the nail-insertion point to the anterior edge of the vertebral body was gradually increased,reached the peak at L4,and decreased at L5,and the difference was significant(P<0.05).There were no significant differences in the width of the left and right pedicles of the same vertebral body,and the distance between the nail-insertion point and the anterior edge of the vertebral body(P>0.05).Conclusion The reesrah results provide the screws of specific diameters and lengths for different vertebral bodies in clinical surgery,which can be safely inserted through specific abduction angles on the horizontal plane,and the screws of the same diameter and length can be inserted in the left and right pedicles of the same vertebral body at the same sagittal angle and opposite horizontal abduction angle.
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