腰椎棘突、椎板及下关节突的影像解剖  

Imaging anatomy of spinous process,lamina and inferior articular process of lumbar spine

作　　者：卢奕霖 陈泽华 蒋佳霖 张朝政 孙璟川 郭永飞 Lu Yilin;Chen Zehua;Jiang Jialin;Zhang Chaozheng;Sun Jingchuan;Guo Yongfei(School of Basic Medical Science,Naval Medical University,Shanghai 200433;Graduate School,Naval Medical University,Shanghai 200433;Department of Spinal Surgery,Changzheng Hospital,Shanghai 200001,China)

机构地区：[1]海军军医大学基础医学院,上海200433 [2]海军军医大学研究生院,上海200433 [3]长征医院脊柱外科,上海200001

出　　处：《解剖学杂志》2021年第4期319-322,F0003,共5页Chinese Journal of Anatomy

基　　金：上海市科委2017科技创新行动(17441900400)。

摘　　要：目的:测量国人腰椎4、5(L4、L5)棘突、椎板及下关节突相关解剖学结构,为设计最优化的椎弓根螺钉-翼状曲面钢板系统提供数据基础,为下一步临床试验奠定基础。方法:选取长征医院患者的脊柱三维CT影像学资料,并将其通过3D打印技术建立模型,采用不同影像学测量方法及在3D模型上进行实物测量的方法,获得L4、L5棘突厚度、棘突侧面大小、下关节突厚度、椎板与棘突成角、下关节突与椎板成角、下关节突与棘突成角、棘突根部至上关节突根部的距离等数据。结果:男、女性测量结果差异没有统计学意义。以男性为例,L4的棘突边距、棘突中央高度分别为(24.55±2.31)mm、(23.06±2.89)mm,L5的棘突边距和棘突中央高度则分别为(20.87±2.61)mm、(21.52±3.08)mm,两椎体的棘突厚度均呈从上至下增厚的趋势。在L4,棘突根部至上关节突根部距离、棘突侧面与下关节突面夹角、下关节突面与椎板面夹角(A2)、下关节突面中心处矢状线方向厚度和下关节突面中心处垂直于下关节突面方向的厚度分别为(10.33±1.03)mm、(149.74±6.40)°、(140.53±12.33)°、(10.51±0.53)mm、(10.98±0.65)mm;在L5,由于3D打印模型的L4、L5为一个整体,影响了A2的测量,其他指标分别为(16.42±1.66)mm、(146.47±7.90)°、(11.38±0.86)mm、(10.15±0.62)mm。结论:国人脊柱L4、L5椎板、棘突及上、下关节突的解剖学数据可为腰椎峡部翼状曲面钢板的设计研发提供精确参考。Objective:To measure the anatomical structures of spinous process,lamina and inferior articular process of L4 and L5 in Chinese,so as to provide data basis for the optimal design of pedicle screw pterygoid curved plate system and lay the foundation for further clinical trials.Methods:The imaging data of 33 patients visiting our hospital were collected and used to print 3D structural models.The thickness of L4 and L5 spinous process,the side size of spinous process,the angle between the laminar of vertebral arch and spinous process,the angle between the laminar of vertebral arch and inferior articular process,the angle between inferior articular process and spinous process,the distance between the root of spinous process and the root of inferior articular process were obtained by different imaging measurement methods and physical measurement of 3D models.Results:No significant different was observed between men and women.In males,the margin and the central height of spinous processes of L4 were(24.55±2.31)mm and(23.06±2.89)mm,respectively.The distance between upper and lower edge of spinous process and the distance between anterior and posterior edge of L5 were(20.87±2.61)mm and(21.52±3.08)mm,respectively.The thickness of the spinous process of both vertebrae tended to increase from top to bottom.In L4,the distance from the root of the spinous process to the root of the superior articular process,the angle between spinous process side and inferior articular surface,the angle between inferior articular surface and lamina surface(A2),the sagittal thickness of the inferior articular process and the vertical thickness of inferior articular process were(10.33±1.03)mm,(149.74±6.40)°,(140.53±12.33)°,(10.51±0.53)mm,(10.98±0.65)mm,respectively.Because L4 and L5 of the 3D models were printed as a whole,A2 of L5 was not measured,and the other parameters were(16.42±1.66)mm,(146.47±7.90)°,(11.38±0.86)mm,(10.15±0.62)mm,respectively.Conclusion:The anatomical data of L4 and L5 lamina,spinous process,superior and i

关 键 词：椎弓根钉 腰椎 峡部 影像解剖 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学]