在腰椎斜位片上判断椎弓根螺钉进钉深度的放射解剖学研究  

Radiological anatomical study on identifying the entrance depth on lumbar spine oblique film

作　　者：杜心如[1] 赵玲秀[2] 张一模[2] 孔祥玉[2] 万荣[1] 

机构地区：[1]承德医学院附属医院骨科,河北承德067000 [2]承德医学院解剖学教研室,河北承德067000

出　　处：《中国临床解剖学杂志》2003年第1期22-24,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的 :探讨利用腰椎斜位片判断椎弓根螺钉进钉深度的科学性和可行性。方法 :在 3 3套腰椎骨标本上按人字嵴顶点进钉方法打入椎弓根螺钉 ,拍腰椎横断面片 ,其中 18套拍腰椎左右前斜位片 ,观察进钉角度与螺钉穿出椎体前侧骨皮质部位的关系及螺钉顶端与椎体前方骨皮质显影的关系。结果 :该进钉方法的出钉点 76.6%位于椎体前侧方 ,6.3 %位于椎体侧方。斜位片上螺钉顶端 63 .9%恰位于前侧方骨皮质显影处 ,18.3 %螺钉顶端距前侧骨皮质 1mm。结论 :斜位片上椎体前方显影部位是椎弓根螺钉穿出骨皮质的部位 ,当进钉角度在 5～ 10°时 ,斜位片可准确地判断螺钉进钉深度 ,此判断方法简单、实用 ,适于推广。Objective: To discuss how to identify the entrance depth of pedicle screw on lumbar spine oblique film. Methods: Pedicle screws were inserted into 324 pedicles (in 169 vertebrae) according the method of the top point of the '∧' shape crest introduced by us.The superoinferior, left and right oblique roentgenographs were performed.The relationship between the top end of wire and lateral cortex of vertebra body was observed; the quantitative relations between the entrance angle of pedicle screw and exit position of it was also described.Results: The exit position of pedicle screw was located at the anterolateral cortex of vertebrae in 76.6% specimens, at the lateral part in 6.3% specimens as the entrance angle was 5～10°,at the anterior cortex in 17.7% specimens as the entrance angle was 10～20° in the superoinferior film.The projection of the screw top end was in the projection of the anterolateral cortex of vertebrae in 63.9% specimens on the oblique film, and the distance between the two projections were less than 1 mm in 18.3% specimens. Conclusion: The anterolateral cortex of vertebrae body where the pedicle screw top penetrates through is the projection part of vertebrae body on lumbar spine oblique film. The entrance depth of pedical screw can be easily accurately identified on lumbar spine oblique film.

关 键 词：腰椎 椎弓根 螺钉 深度 放射学 

分 类 号：R681.5[医药卫生—骨科学]