CT三维重建青少年胸椎椎弓根断面测量的解剖学研究

The anatomical measurement of adolescent thoracic pedicle on CT 3-D reconstruction

目的为青少年胸椎椎弓根内固定术提供解剖学数据。方法多排螺旋CT对正常青少年(14～17岁)46例自愿者进行胸椎扫描,三维重建后,测量椎弓根高、椎弓根宽、椎弓根骨松质宽及椎弓根骨松质高,观察椎弓根内部骨质分布情况。结果椎弓根宽呈两端大、中段小的变化趋势,T4最小(3.85±0.77)mm,T1最大(8.12±1.39)mm;椎弓根高为逐渐增加的波浪形曲线,T3小峰:(10.93±0.88)mm,T12最大:(15.68±1.25)mm;椎弓根骨松质宽为先减小后增大,T11最大(5.24±1.3)mm;椎弓根骨松质高T4最小(5.74±2.4)mm,T11最大(13.18±2.3)mm。结论青少年胸椎真正能决定螺钉直径的是骨松质宽,椎弓根螺钉置入时应结合影像学资料,选择合适的螺钉及进钉部位和方向。

Objective To provide the anatomical data for teenagers thoracic pedicle fixation.Methods Using multidetector-row CT for scanning the thoracic spine of 46 volunteer normal teenagers（14~17-year-old）;after the reconstruction,measurement of height and width of pedicle cancellous bone and pedicle cancellous bone was made,observation of bone structure of the pedicle was carried out.Results The width of the pedicle assumed a trend of being large at the sides and small at the middle,T4 minimum（3.85±0.77） mm,T1 maximum（8.12±139） mm;the height of the pedicle assumed an gradually increasing wavy curve,T3（10.93 ±0.88） mm,T12 maximum（15.68±1.25） mm;Pedicle cancellous bone wide first decreases,T11 maximum（5.24±1.3） mm;Pedicle cancellous bone high T4 minimum（5.74±2.4） mm,T11 maximum（13.18±2.3） mm.Conclusion It is the cancellous bone that really decides the diameter of the screw;during the placement of the screw,its direction and site should be guided by the imaging materials.