腰椎椎弓根轴心线与椎板外缘夹角的测量及其临床意义

The angle between the pedicle axis of lumbar vertebrae and the lateral border of vertebral plate:the measurement and clinical significance

目的测量腰椎的椎弓根轴心线与椎板外缘所成的夹角,探讨其临床意义。方法采用计算机和人工相结合的方法,测量100例成人志愿者和15具成人尸体腰椎标本的椎弓根轴心线与椎板外缘夹角。结果志愿者的X线片上所测夹角L1～5分别为90.7°±3.0°,92.8°±3.0°,94.6°±2.3°,96.6°±2.6°,100.5°±3.2°;各组间均有显著差异(P<0.05);性别间无显著差异(P>0.05);在尸体标本上所测夹角分别为89.8°±3.3°,91.9°±2.7°,93.8°±2.4°,95.1°±2.4°,99.2°±3.6°,各组间均有显著差异(P<0.05);左右侧无显著差异(P>0.05)。X线片上与尸体标本上测量的L1、L2、L3的角度无显著差异(P>0.05),而L4、L5的角度有显著差异(P<0.05)。结论手术时将椎弓根螺钉按椎弓根轴心线与椎板外缘所成的夹角置入,可以提高螺钉置入的准确性。

Objective To measure the angle between the pedicle axis of lumbar vertebrae and the lateral border of vertebral plate and discuss its＇ clinical significance.Methods 100 adult volunteers and 15 human lumbar spine specimens were chose to measure the angle between the pedicle axis of lumbar vertebrae and the lateral border of vertebral plate by the computer and the protractor,and then the collected data were compared and analyzed.Results The angles obtained from X-ray images of volunteers were respectively,from L1 to L5,90.7°±3.0°,92.8°±3.0°,94.6°±2.3°,96.6°±2.6°,and 100.5°±3.2°.Significant differences appeared among different groups （P〈0.05）,but no gender difference appeared （P〈0.05）.The angles obtained from lumbar spine specimens were respectively 89.8°±3.3°,91.9°±2.7°,93.8°±2.4°,95.1°±2.4°,and 99.2°±3.6°.As the results of X-ray data,there were significant differences among different groups （P〈0.05）,and no gender difference.Compared the data from X-ray images and specimens,there was no significant difference in L1,L2 and L3 （P〈0.05）,despite of the significant differences among L4 and L5 （P〈0.05）.Conclusions The insertion accuracy may be improved if the angle between the pedicle axis of lumbar vertebrae and the lateral border of vertebral plate can be used as the reference for the insertion of the pedicle screw.