【摘要】 目的探讨胸腰段椎弓根CT测量在椎弓根螺钉内固定中的作用,寻找一种个体化椎弓根螺钉置入的方法,提高置钉的成功率。方法选用5例脊柱标本,每例标本的T11-L2均经螺旋CT断层扫描后,图像输入到计算机软件,对图像进行处理,测量T11-L2椎弓根各径线的数据,并根据数据模拟出各椎弓根的形态特点,计算在考虑和未考虑螺钉直径的情况下进行置钉的安全角度的范围,依测量的数据和计算的角度在标本上置钉,再行CT扫描观察螺钉在椎弓根内的位置。结果在未考虑螺钉直径的情况下,沿椎弓根轴线在T11-L2横断面上置钉的平均最大安全范围平均为24.30、24.30、21.70、23.10,在矢状面为44.30、44.30、42.80、40.00,用直径为5mm螺钉植入时,在横断面平均最大安全范围是9.10、9.60、10.50、9.60,在矢状面是31.30、31.20、29.70、27.70,这些数据的差异具有显著性(P<0.05),置钉时应考虑螺钉直径。结论利用三维CT测量的数据辅助,严格按照个体化的椎弓根的轴线方向植钉,在置钉时应考虑到螺钉本身直径的因素,以提高植钉的成功率。更多还原

【Abstract】 [Objective] To observe the role of spinal CT measurement in the transpedicular screw fixation in thoracolumbar vertebral arch and seek a good and simple personal method of improving the accuracy rate of transpedicular scew.[Methods]Five thoracolumbar specimens of adults,was used,the spiral computed tomography scan of thoracolumbar specimens were taken,then the image data were send to the software to measure the liner parameters of pedicle from T11~L2,and simulate topography of thoracolumbar vertebral arch,respectively calculate the inserting angular safe range with and without consideration of the diameter of the screw.Specimens were then fixed at T11~L2 by screw according to above results.Accuracy of placement was assessed by postoperative CT scan.[Results] Neglecting the diameter of the screw,the average inserting angular safe range of T11~L2 in transverse plane were 24.30,24.30,21.70,23.10 respectively,and 44.30,44.30,42.80,40.00 in sagittal plane respectively;then concerning the diameter of the scew(5.0 mm),the data became 9.10,9.60,10.50,9.60 and 31.30,31.20,29.70,27.70 respectively(P <0.05).[Conclusion] The insertion of pedicle screw is safe on the base of three-dimension CT measurement,while transpedicular screw fixation must be strictly operated according to the axis of the pedicle.更多还原