胸腰段脊柱运动节段矢状面成角的测量及临床意义

The measurement and clinical significance of the angle on sagittal plane of the thoraco-lumbar athletic segment

目的:为钉棒系统治疗胸腰段脊柱骨折时棒的折弯角度个性化设计提供依据。方法:在50例正常人胸腰椎侧位片上测量T10到L3各运动节段及各椎体的矢状面成角,目标椎体运动节段的矢状面成角以上下运动节段矢状面成角均值替代(均值法),预测目标椎体的cobb角并与实际测量值统计学分析。结果:T11、T12、L2各椎体cobb角的预测值并与其实际测量值对比差异无统计学意义(P>0.05);L1椎体cobb角的预测值与实际测量值对比差异有统计学意义(P<0.05),但相差值均值1.06°,最高2.56°。结论:脊柱胸腰段运动节段矢状面成角存在分布规律,采用"均值法"得出目标椎体的矢状面成角,并以此角度来参与计算预测目标椎体的cobb角,可较为准确的预测目标椎体cobb角,从而为临床手术治疗胸腰段脊柱骨折患者时预测骨折椎体的cobb角提供依据。

Objective： To provide the evidence of individual angular design of stick in curing fractures of thoraco-lumbar vertebrate.Methods： To measure the angles on sagittal plane of every athletic segment and vertebral body of fifty healthy adults.The average value on sagittal plane of its upper and subtus athletic segment is regarded as the angle on sagittal plane of the objective athletic segment.The predictive value and actual measured value were analyzed by statistics.Results： There was no significant measurement differences between predictive cobb value and actual measured value for T11,T12 and L2（P0.05）.There were significant measurement differences between predictive cobb value and actual measured value for lumbus（P0.05）.Conclusion： The cobb angle of thoraco-lumbar vertebrate on sagittal plane exist regularity,Utilizing this regularity the cobb angle can be concluded before fractured and can regain the physiologic curve of the fixed thoraco-lumbar segment.