【摘要】 目的通过测量T1-8节段胸椎肋椎关节的形态学特征,探讨经肋椎关节进钉的可行性及临床意义。方法选择12具国人胸椎标本(男7、女5)共96个椎体,选取T4-5节段,使用康辉6.0 mm椎弓根螺钉进行经椎肋关节内固定,并使用X线评估螺钉置入位置,并实体测量T1-8每个椎体肋椎关节及相应节段椎弓根的横径、钉道长度及e角(肋椎关节、椎弓根轴线与矢状线的夹角)。结果各节段肋椎关节的横径均明显大于椎弓根(P<0.01);经肋椎关节植入螺钉可提供的钉道长度明显优于椎弓根(P<0.01);经肋椎关节植入螺钉的e角普遍大于椎弓根钉(P<0.01)。影像学结果显示:所有螺钉均处于椎肋关节中未进入椎管及突破外侧肋骨。结论从解剖学研究的角度看,经肋椎关节植入螺钉的安全性优于传统的椎弓根内固定。更多还原

【Abstract】 Objective To evaluate the morphology of costovertebral joints in the normal thoracic spine(T1-8),and to explore the feasibility and clinical significance of thoracic extrapedicular fixation.Methods 6.0 mm Kanghui pedicle screws were placed in T4-5 through an extrapedicular approach in 12 adult cadavers.The position of each screw was analyzed by X rays.The transverse diameter,length of screw path and angle e(the angle between the pedicle rib unit and the processus spinosus) of costovertebral joints in T1-8 were measured and compared to those of adjacent pedicles.Results The transverse diameter,length of screw path and angle e of costovertebral joint were significantly larger than those of adjacent pedicles(all P<0.01).All screws were within the costovertebral joints and did not penetrate to the spinal canal or rib.Conclusion Thoracic extrapedicular fixation is safer than transpedicular fixation in the upper and middle thoracic spine.更多还原