胸腰段骨折后上缘骨折块的地图研究  

Map study of posterior upper margin fracture block of thoracolumbar fracture

作　　者：高德强 郭小波 郭登升 Gao Deqiang;Guo Xiaobo;Guo Dengsheng(Changzhi Medical College,Changzhi,Shanxi 046000,China;Spinal Minimally Invasive Orthopedics,Jincheng Hospital,Jincheng,Shanxi 048000,China)

机构地区：[1]长治医学院,山西长治046000 [2]晋城大医院脊柱微创骨科,山西晋城048000

出　　处：《齐齐哈尔医学院学报》2024年第23期2245-2250,共6页Journal of Qiqihar Medical University

基　　金：山西省卫生健康委员会“四个一批”科技兴医创新计划(2021XM39)。

摘　　要：目的 通过运用3D重建与骨折地图技术分析胸腰段骨折后上缘骨折块的形态特点,为临床手术减压提供参考。方法 回顾性分析2017年1月-2024年1月本院收治的103例患者胸腰段椎体骨折(T12、L1)后上缘骨折块的薄层CT数据,利用Mimics Research 21.0进行三维重建,并将每个骨折块作为单独实体分离,然后导入到3-matic Research 13.0软件中,进行复位后整合。随后导入E-3D Medical 23.00软件中,骨折实体与模板重合后,在模板上绘制出后上缘骨折块与主体之间骨折线,然后生成骨折线图和热图。利用线性相关分析,探讨骨折块长、宽、高与患者性别、年龄及体重之间的相关性。结果 从热图中可看出骨折线集中区域呈环形分布,矢状位在椎体的中柱,冠状位在双侧椎弓根之间。Pearson线性相关提示:T12组中骨折块的高与性别具有相关性(P<0.05,r=0.365);L1组中骨折块的前后径与性别具有相关性(P<0.05,r=0.320)。结论 T12、L1椎体后上缘骨折块地图的研究明确了骨碎片的形态特征,为椎弓根螺钉内固定术和经皮穿刺椎体成形术提供了参考。Objective To analyze the morphological characteristics of the posterior upper margin fracture block in thoracolumbar fractures using 3D reconstruction and fracture mapping technology,in order to provide a reference for clinical surgical decompression.Methods In this study,thin-slice CT data of the posterior upper margin fracture blocks of 103 patients with thoracolumbar vertebral fractures(T12,L1)admitted to Jincheng Hospital from January 2017 to January 2024 were retrospectively analyzed.Mimics Research 21.0 was used for 3D reconstruction,and each fracture block was isolated as a separate entity,then imported into 3-matic Research 13.0 software for post-reset integration.Subsequently,it was introduced into E-3D Medical 23.00 software.After the fracture entity coincided with the template,the fracture line between the posterior upper margin fracture block and the main body was drawn on the template,and then the fracture map and heat map were generated.Linear correlation analysis was used to investigate the correlation between the length,width,and height of the fracture block and the patients'gender,age,and weight.Results From the heat map,it can be observed that the fracture line concentration areas are distributed in a ring-like pattern,with the sagittal position in the middle column of the vertebral body and the coronal position between the bilateral pedicles.Pearson's linear correlation indicated that in the T12 group,the height of the fracture block was correlated with gender(P<0.05,r=0.365);in the L1 group,the anteroposterior diameter of the fracture block was correlated with gender(P<0.05,r=0.320).Conclusions The study of the T12 and L1 posterior upper margin fracture block maps clarified the morphological characteristics of the bone fragments,providing references for pedicle screw fixation and percutaneous vertebroplasty procedures.

关 键 词：椎体骨折 计算机断层扫描 三维图像 骨折地图 

分 类 号：R687.3[医药卫生—骨科学]