正常腰椎峡部CT解剖学研究

Anatomical study of normal isthmian part of lumbar vertebral arch via CT

目的 :为提供腰椎峡部CT解剖学资料。方法 :5 0例正常成年人腰椎峡部定位CT扫描 ,观察与腰椎峡部裂行多孔面螺钉进针方向、角度等的有关数据。结果 :L1～ 3 两侧峡部外侧宽基本接近 ,平均为 ( 2 6.3± 4.4)mm ;L4宽度略增 ,L5宽度最大 ,为 ( 4 0 .3± 5 .8)mm。L1～ 3 与L5间存在显著性差异 (P <0 .0 5 )。在矢状面上 ,L1～ 4峡部的走行方向基本上呈垂直向下 ,连接于上下关节突之间 ,L5峡部明显向后上倾斜 ,故在上关节突与峡部之间形成平均角度为 ( 10 3± 7°) ( 90～ 110°)的仰角。在冠状位上 ,随着椎间孔不断增大 ,腰椎峡部逐渐外移 ,L5峡部极度外移 ,使下关节突移至上关节突外下方。结论 :做L3 峡部裂多孔面螺钉内固定时 。

Objective: To supply anaomical basis for the study of isthmian part of lumbar vertebral arch CT.Method:Fifty cases of adult normal isthmian part of lumbar vertebral arch were scanned via CT.The screw of porous side entry route and angle were observed.Result:The lateral width of isthmi was almost identical;the average width was (26.3±4.4)mm.The width of L_4 increased.The width of L_5 was (40.3±5.8)mm,and there was significant difference berween L_(1～3) and L_5 (P<0.05).In the sagittal plane L_(1～4) were vertically downward from upward,connecting supcrior and infcrior process articular.Because the isthmian of L_5 obviously inclined to the back and upper,there formed an angle between isthmian and superior procesaarticular.The average angle was 103°±7°(90°～110°).In coronal plane,the foramen intervertebral became larger,and isthmian rumed outside.The isthmian of L_5 turped extremely outside,and the inferior proccss articular moved to outside and dounward of the articular.Conclusion:When spondylolysis of L_5 is treared with screw of porous side,the angle between isthmian and superior process.Articular must be taken into cosideration.