摘要
目的 :为椎弓根螺钉内固定术提供解剖学基础。方法 :3 0例 (C2 ～L5)脊柱骨标本 ,用CT观测椎弓根最窄处皮质及髓腔的宽和高。结果 :各椎弓根髓腔 (骨松质 )宽呈相互衔接的三个“马鞍”形趋势 ,即四个高峰三个低谷值 ,依次为C2 (高 )、C4～ 5(低 )、T1(高 )、T4(最低 )、T12 (高 )、L1(低 )及L5(最高 ) ;髓腔高值颈段呈“马鞍”形 ,从C5～L5则有渐增大趋势 ;各椎弓根皮质及髓腔的宽和高值均有明显的规律性变化 ,各段同一椎弓根骨质皮厚度上、下缘近似相等而内、外缘厚度比颈、胸、腰分别约为 3∶1、2∶1及 1∶1。结论 :螺钉直径主要取决于髓腔宽 ,但C2 ～T1段 ,特别是C6、C7须同时参照髓腔的高和宽 ,C3～ 6和T4～ 6段仅能用约 3 .0mm直径的螺钉。
Objective: To provide the anatomic basis for the use of transpedicular screw fixation.Methods: By means of CT laminagraphy, observations and measurements had been taken from C 2 to L 5 in 30 intact skeleton specimens, and the following were record: the width of pedicle cortex and medullry cavity (WPC and WPMC),the height of pedicle cortex and medullary cavity (HPC and HPMC). Results: Every WPMC showed three 'saddle' shapes with four 'peak' and three 'valley' values, namely C 2 (high), C 4～5 (low), T 1(high),T 4(lowest),T 12 (high),L 1(low) and L 5(highest).HPMC showed 'saddle' shape with cervical region, those from C 5 to L 5 showed gradual increase downward, and there were a clear regularity on the width and height with WPC, WPMC, HPC and HPMC;The thickness of every pedicle around border suggested an regularity that superior and inferior borders were nearly equal, but the proportion on medial and lateral borders were nearly 3∶1 with cervical region, 2∶1 with thoracic region, and the lumbar region was nearly 1∶1.Conclusions: The diameter of screw should be guided by both HPMC and WPMC mainly, but in C 2～T 1 region, C 6 and C 7 especially should be guided by both HPMC and WPMC, and the transpedicular screw which is approximately 3.0 mm long were suitable for C 3～6 and T 4～6 region.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2003年第1期37-40,共4页
Chinese Journal of Clinical Anatomy
关键词
椎弓根
骨皮质
髓腔
螺钉直径
CT
pedicle
cortical bone
medullary cavity
screw diameter
