腰椎弓峡部裂多孔面螺钉内固定术的解剖学基础

Anatomic basis of internal fixation with screws of porous side for lumbar spondyloschisis

目的：为腰椎弓峡部裂多孔面螺钉内固定术提供解剖学依据。方法：成人干燥Ｌ３、４、５椎各３０个，测量与术式有关的进钉部位、方向、角度、长度等数据；Ｌ３、４、５椎各５个，行椎板下缘、峡部、椎弓根锯开，作剖面骨密质厚度测量。结果：椎板下缘最厚处平均Ｌ３为８．５ｍｍ，Ｌ４为８．３ｍｍ，Ｌ５为７．７ｍｍ。距离棘突中线Ｌ３为１１．５ｍｍ，Ｌ４为１４．０ｍｍ，Ｌ５为１６．８ｍｍ。峡部中部厚度Ｌ３为８．９ｍｍ，Ｌ４为９．８ｍｍ，Ｌ５为９．６ｍｍ。进钉点至椎弓根上切迹距离Ｌ３为３．７ｃｍ，Ｌ４为３．５ｃｍ，Ｌ５为３．２ｃｍ。进钉角度向上向外与矢状面呈１５°～１７°。结论：以上数据可供术者因人、椎序酌情选用多孔面螺钉及操作时参考。

bjective:To provide anatomic data for internal fixation of lumbar spondyloschisis with screws of porous side.Methods:The location,direction,angle and length to set in the screw were measured on 60 sides of adult dry lumbar vertebral 3,4,5;The thickness of compact bone were measured on inferior border of lamina,isthmian part and pedicle of vertebral arch.Results:The most thick part of inferior lamina border was 8.5 mm on L3,8.3 mm on L4 and 7.7 mm on L5.The medial thickness of isthmian part was 8.9 mm on L3,9.8 mm on L4 and 9.6 mm L5.The distances between the point to set the screw in and the superior vertebral netch were 3.7 cm in L3,3.5 cm in L4 and 3.2 cm in L5.The angle that the screw set in was 15～17 degree to the sagittal plane.Conclusions:These data could help operator to use the screw of porous side according to different cases or different vertebra.