骶骨的畸形变异

ABNORMALITIES AND VARIATIONS OF THE SACRUM

1.本文就400例骶骨标本及800例有关X光像进行研究。2.骶骨常见之畸形变异有骶骨节数之增减;隐性脊柱裂及浮棘等,骨胳标本之研究中发现具正常5节者285例,占71.2%,骶尾椎62例,占15.5%,腰椎骶化22例,占5.5%,骶椎腰化13例,占3.3%,其他18例,占4.5%,S及S有脊柱裂者115例,占28.7%,骶管全部开放者12例,占3%,X光像观察发现具正常5节者640例,占80%,骶尾椎70例,占8.75%,腰椎骶化67例,占8.37%,骶椎腰化7例,占0.87%,S及S有脊柱裂者153例,占19.1%,骶管全部开放者41例,占5.1%,具浮棘者86例,占10.7%。3.本文另就骶管裂孔的大小各径进行测量,其底之横径平均为18.22mm,底至尖之距离平均为26.7mm,尖部之前后径平均为5.45mm,尖部一股对第四五骶椎处。4.上关节突之关节面最常见者为斜位,但也有不少作冠状位及矢状位,两关节突对称者占65%,不对称者占21.7%,显明不对称者13.3%。5.耳状面之范围多位于上二三节间,两侧对称者占86.7%,不对称者占13.3%。6.骶骨之曲度有甚多变化,上直下屈者占17.2%,均匀屈曲者54%,极度屈曲者11.8%,平直者11%,上伸下屈者6%,X光像具水平骶椎者占4.5%。7.骶骨之棘突显示退化,本文就棘突之数目作了分析。8.本文报告二例严重骶骨先天性畸形。9.本文对各种畸形变异之临床意义作了简要之说明。

A study of the abnormalities and variations of the sacrum was made on 400 gross sacral specimens and 800 X-ray films.It consisted of segments,spina bifida occulta,flotting spinous process....etc.The composition of sacrum varied a great deal,the segments ranged from 4 to 9.In the series of gross specimens,with normal 5 segments:285 cases(71.2%);Co became incorporated in sacrum:62 cases(15.5%);sacralisation of L:22 cases(5.5%);lumbarisation of S:13 cases(3.3%);others:18 cases(4.5%);spina bifida occulta located in Sand S:115 cases(28.7%);sacral canal entirely opened:12 cases(3%).While in X-ray film series,with normal 5 segments;640 cases(80%);Co became incorporated in sacrum:70 cases(8.75%);sacralisation of L:67 cases(8.37%);lumbarisation of S:7 cases(0.87%);spina bifida occulta located in Sand S:153 cases(19.1%);sacral canal entirely opened:41 cases(5.1%);flot-ting spinous process:86 cases(10.7%).The size of sacral biatus was measured,the mean width of the base being 18.22mm,the average length between the apex and the base 26.7 mm,the A-P diameter of the canal at the level of apex 5.45mm.The apex was most common-ly located at the level of Sor S.Examination of articular surface of upper articular process showed that they inclined obliquely in most cases,but could also be coronal or sagittal.Both arti-cular surfaces were symmetrical in 65%,asymmetrical in 21.7%,markedly asym-metrical in 13.3%.The articular surface was extending from upper 2-3(1/2)segments,they were found symmetrical in 86.7%,asymmetrical in 13.3%.In the gross specimens,the curve of the sacrum was also studied,straight.superiorly and flexed inferiorly:17.2%,gently flexed:54%,markedly flexed:11.8%,flat and straight:11%,hyperextended superiorly and flexed inferiorly:6%.In the X-ray film series,“horizontal sacrum”was found in 4.5%.The spinous process of the sacrum remained rudimentary,leaving only the tubercle.Its number was studied.2 cases with marked anomaly were reported.One girl aged 1,with rudi-mentary sacrum,only 2 segments,the coccyx wanting,L-Lsacralized.A boy aged 6,had V-shaped defect in the sacrum.Both cases presented remarkable clinical disturbances.The clinical significance relating the abnormalities and variations of the sacrum was briefly discussed.