【摘要】 目的 :对骶骨螺钉上关节突关节面 5点 7点进钉方法进行相关的放射解剖学研究。方法 :在 5 0块骶骨标本上 ,用 为 1mm的软钢丝在骶骨翼、骶骨上关节突处紧紧缠绕 2个钢丝圈 ,将 为 3mm的钢珠用胶布固定在 5点 7点处 ,拍骶骨正位片 ,观测钢珠与 2个钢丝圈的位置关系及其至骶管外侧壁、骶骨上面的距离。作经 5点 7点水平平行于S1椎体上面的CT扫描 ,观察骶骨横断面的形态特点 ,测量与矢状面夹角为 0°和向内 10°时的进钉深度。结果 :5点 7点处钢珠均位于上关节突与S1后孔缠绕的钢丝圈显影内 ,位于骶管侧壁钢丝圈显影的外侧 ,钢珠与骶管外侧壁的距离为左侧〔 ( 6 7± 2 3 ) ( 5 0～ 12 0 )〕mm ,右侧〔 ( 6 6± 1 9) ( 5 0～ 11 0 )〕mm ;此点至骶骨上面的距离为左侧〔 ( 11 5± 5 3 ) ( 5 0～ 2 8 0 )〕mm ,右侧〔 ( 11 6± 5 4) ( 5 0～ 2 9 0 )〕mm。CT片显示钉道与矢状面平行( 0°)时 ,进钉深度左侧为〔 ( 3 2 6± 3 5 ) ( 2 4 0～ 40 0 )〕mm ,右侧为〔 ( 3 2 6± 3 5 ) ( 2 4 0～ 42 0 )〕mm ;螺钉向内与矢状面的夹角为 10°时 ,进钉深度左侧为〔 ( 3 8 1± 3 8) ( 3 0 0～ 46 0 )〕mm ,右侧为〔 ( 3 8 0± 3 9) ( 3 0 0～ 46 0 )〕mm。结论 :骶骨上关节突恒定存在 ,将每侧上关节更多还原

【Abstract】 Objective:To study the placement of inserting sacral screw through the five-seven o’clock point on the articular facet of the superior articular process by radiological anatomical means.Method:The alas and the superior articular processes of the 50 sacra specimens were twined with 1.0 mm diameter steel wire.The 3.0 mm diameter steel ball was fixed on the five-seven o’clock point.The anteroposterior radiographs were performed for observing the relation between the ball and the wire,for measuring the distances from the point to the lateral wall of the sacral canal,and to the superior base of the sacrum.50 sacra were scanned through the five-seven o’clock point by CT for investigating the shape of transverse sections of the sacra,for measuring the depth of screw at 0° and 10° inward to the sagittal plane.Result:According to the X-ray film,the ball was out of the sacral canal.The distance from the ball to the lateral wall of sacral canal was 〔(6.7±2.3) (5.0～12.0) 〕mm on the left,〔(6.6±1.9) (5.0～11.0)〕 mm on the right.The distance from the ball to the superior base of the sacrum was 〔(11.5±5.3) (5.0～28.0)〕 mm on the left and 〔(11.6±5.4) (5.0～29.0)〕 mm on the right.On the CT scans,the entrance depth of the sacral screw was 〔(32.6±3.5 )(24.0～40.0) 〕mm on the left,〔(32.6±3.5)(24.0～42.0)〕 mm on the right at 0° and 〔(38.1±3.8) (30.0～46.0)〕 mm on the left,〔(38.0±3.9) (30.0～46.0) 〕mm on the right at 10° inward to the sagittal plane.Conclusion:The entrance point of the sacral screw:The superior articular processes of sacrum exist unvaryingly.If the articular facet of the superior articular process is regarded as a clock,the entrance point of sacral screw is at the five o’lock point on the right,and at the seven o’clock point on the left.The depth and the length of the sacral screw can be depended on X-ray films and CT scans.The depth of the sacral screw is 30.0～35.0 mm at 0° and 30.0～40.0 mm at 10°.The point of the sacral screw is located in the medial part of the safe triangular zone.更多还原