第一骶骨椎弓根的形态观测及临床应用

The anatomical measurement of the pedicle of vertebral arch of the first sacral vertebrae and its clinical application

目的改进第一骶椎椎弓根螺钉的进入方法。方法用60个成人骶骨测量第一骶椎的椎弓根的如下指标:1)椎弓根的高度和宽度;2)螺钉通道的长度;3)椎弓根的展角。基于所测结果,应用于12具成人尸体和24例病人。结果第一骶椎椎弓根的高度为20.6±3.4 mm;宽度为23.8±2.2 mm;穿刺深度为52.2±5.0 mm;进钉点在腰椎关节突中点下方10.2±2.0 mm,后正中线外侧32.3±3.6 mm处;外展角度为40±3°。临床应用24例,随访提示平均滑脱纠正率72.5%。结论以此改良的穿刺角度和穿刺点数据指导临床应用,可改善疗效,提高安全性。

Objective： To improve the insertion technique of sacrum transpedicle screw. Methods： 60 human adult sa-crum specimens were used to study the following parameters： 1 ） the height and the width of the pedicle of vertebral arch of the first sacral vertebrae; 2 ） the length of screw passage; 3 ） the angle between the axis of pedicle of vertebral, arch and the median sagittal plane. Based on the measurements, 12 adult cadavers and 24 patients were applied, the results were satis-factory. Results： The average height was 20.6 ± 3.4 mm, the width 23.8 ± 2.2 mm, the length of screw passage 52.2 ± 5. 0 mm. The point of puncture was 10.2 ± 2.0 mm below the midpoint of the zygapophysial joint, 32.3 ±3.6 mm lateral to the posterior median line. The abdueent angle was 40 ± 3 degree. The clinical application in 24 eases indicated that the average correction rate was 72.5%. Conclusion： It can improve the curative effect and increase the safety by the use of the improved data of insertion angle and site of sacrum transpedicle screw.