胸腰椎椎弓根的解剖学测量及其临床意义

Anatomical measurement of the pedicles of thoracolumbar vertebral arch and their clinical significance

目的 观测胸腰椎椎弓根形态结构特征 ,为临床提供解剖学参数。方法 测量 31例成年男性椎骨T1～L5的横径、矢径、椎弓根间距及椎弓根通道长度。结果 横径 :T1～T6逐渐变小 ,T6～T12 逐渐增大 ,L1和L2 小于T12 ,L2 ～L5逐渐增大 ;矢径 :T1～T3 逐渐增大 ,T4～T7均小于T3 和T8,T7～T12 又逐渐增大 ,L1～L3 逐渐变小 ,L3 ～L5又逐渐增大 ,T1～L5均明显大于其横径 (P <0 0 1) ;模仿弓根通道长 :T1～T10 逐渐增长 ,T11和T12 均较T10 和L1短 ,L1～L4逐渐增长 ,L5较L4短 ;椎弓根间距 :T1～T4逐渐变窄 ,T5～L5逐渐增宽 ;左右侧比较无显著性差异 (P >0 0 5 )。结论 进行椎弓根螺钉固定时应根据不同节段椎弓根形态特点 ,结合影像学资料 ,选择相应的螺钉直径、长度、进钉部位及方向。

Objective To observe the morphologic features of the pedicles of thoracolumbar vertebral arch and to provide anatomical data for clinic.Methods The transverse and sagittal diameters,distance between two pedicles,length of pathway through pedicle from T 1 to L 5 were measured in 31 dry adult male skeletons.Results The transverse diameter decreased gradually from T 1 to T 6,increased gradually from T 6 to T 12.The transverse diameters of L 1 and L 2 were lesser than T 12.From L 2 to L 5,the transverse diameter gradally increased again.The sagittal diameter increased gradually from T 1 to T 3,from T 7 to T 12 and from L 3 to L 5,but it decreased gradually from L 1 to L 3,and the sagittal diameters from T 4 to T 7 were lesser than T 3 and T 8.The sagittal diameters from T 1 to L 5 were bigger than their transverse diameter(P<0.01).The lengths of pathway through pedicle increased gradually from T 1 to T 10 and from L 1 to L 4.The lengths of T 11 and T 12 were shorter than T 10 and L 1 respectively.The length of pedicle pathway of L 5 was shorter than T 4.The distance between pedicles of vertebral arch decreased gradualy from T 1 to T 4,increased gradually from T 5 to L 5,but it was no side difference(P>0.05).Conclusion We should choose corresponding bolts′ length,diameter,corresponding direction and position according to the morphologic features of different pedicles of vertebral arch combing with their image data when we carry out fixation through pedicles of vertebral arch combing with their image data when we carry out fixation through pedicles of vertebral arch.