腰椎椎弓根螺钉人字嵴顶点进钉方法的放射解剖学研究

Radiological Anatomical Study of Accuracy Entrance Point for the Placement of Pedicle Screw through Posterior Approach

目的 探讨腰椎椎弓根螺钉人字嵴顶点进钉方法的科学性。方法 在 31套腰椎骨标本上 (310个椎弓根 )用 1mm软钢丝在椎弓根最狭窄处缠绕 ,按人字嵴顶点进钉的方法打入椎弓根直钢丝 ,摄正、侧及横断面片 ,观测直钢丝在椎弓根内的位置及关系。结果 在 14套腰椎标本上用直径 3mm钢珠固定在人字嵴顶点处 ,在腰椎正位片上观察钢珠与椎弓根显影的位置关系。椎弓根在正位片的显影的部位是其最狭窄的部位。结论 人字嵴定位方法 ,进钉角度在 5°～ 10°时 ,钢丝通过椎弓根中心 ,准确率高。

Objective To discuss the relationship between the top point of the“人”shape crest of the lumbar spine with its pedicle center.Method The 310 pedicles in 31 vertebrae specimens that were twined with the wire of 1 0mm in diameter which were taken for radiolgical study.The relationship between the top point the “人”shape crest with the pedicle,center were observed;the steel bead were fixed on the top point of the “人”shape crest in 70 vertebrae.The anteroposterior roentgenograph were performed.Results The screw entrance point of the method was almost in the center of the pedicle when the screw slant obliquely outward at an angle of 5°～10°in L 1～L 4、10°～15°in L 5.Conclusion The new landmark of screw entrance point leads to a very high success rate of screw insertion through posterior approach in lumbar spine.