胸椎关节突关节解剖学测量与经关节螺钉固定的关系

Quantitative Anatomy of the Thoracic Facet and Its Relationship with the Transarticular Screw Fixation

目的测量胸椎关节突关节的相关数据,并探讨与经关节螺钉固定的关系。方法选取20具福尔马林液体浸泡保存的成人尸体胸椎标本,去除所有肌肉、韧带等软组织,对胸椎每个节段从椎间盘和关节间隙进行游离,清楚暴露出各个关节面。测量胸椎关节突关节上、下关节面的高度、宽度和厚度,分析与经关节螺钉固定的关系。结果胸椎关节突关节的关节面高度、宽度和厚度的左右侧数据稍有不同,但无明显统计学意义(P>0.05)。胸椎上关节面的高度9.10～11.21mm,宽度8.45～11.07mm,厚度3.87～5.71mm;胸椎下关节面的高度10.65～12.59mm,宽度9.80～12.60mm,厚度4.20～6.01mm。结论胸椎关节突关节复合体有着足够的皮质骨供螺钉行跨关节固定,胸椎经关节固定也许可以作为椎弓根螺钉应用的一种补充方法。

Objective To quantitatively evaluate the thoracic facet and analyze its relationship with the transarticular screw.Methods Twenty thoracic spines were directly evaluated. Anatomic evaluation of the thoracic superior and inferior facets included the facet height, width, and thickness.Results The thoracic superior facet height, width, and thickness were about 9.10-11.21 mm, 8.45-11.07 mm,and 3.87-5.71 mm respectively.The thoracic inferior facet height, width, and thickness were about 10.65~12.59 mm,9.80-12.60 ram,and 4.20- 6.01 mm respectively.The screws can be inserted caudally and laterally to perforated the facet complex.Conclusion There are in enough cortex of the facet complex for placing tansarticular 4.0-5.0mm screws in the thoracic spine. Posterior tansarticular screw fixation may af- fords an altenaative to standard screw placement for thoracic stabilization.