胸腰椎影像学测量及其临床意义

The image measure of the thoracolumbar by spiral CT and its clinical significance

目的通过测量国人脊柱胸腰段(T11～L4)椎体高度、矢状径、横径,为设计胸腰椎椎体内固定器提供理论依据。方法健康正常人50例(男女各25例),年龄18～60岁(平均30.6±10.5岁),无腰椎病变者行CT扫描,分别测量胸腰椎椎体高度及椎体上、中、下矢状径和横径。结果胸腰椎椎体高度从T11～L4逐渐增高,中央高度与前缘高度、后缘高度比较,以中央高度最小,其范围为20.45～25.55mm(女:19.77～25.30mm),前缘高度为21.24～27.41mm(女:20.84～26.22mm),后缘高度为22.60～26.76mm(女:21.68～26.14mm);正中矢状径、横径从T11～L4逐渐增大,椎体中部的矢状径和横径与椎体上、下的矢状径和横径比较,有显著差异(P<0.05),以腰部最小,其范围分别为28.56～33.36mm(女:27.63～31.42mm)、32.71～46.57mm(女:31.68～44.83mm)。椎体上矢状径和横径范围分别为30.67～37.71mm(女:29.23～36.51mm)、36.85～51.81mm(女:34.31～48.89mm)。椎体下矢状径和横径范围分别为32.24～39.31mm(女:31.14～37.99mm)、38.97～52.94mm(女:37.88～50.80mm)。总体观椎体上下呈向中间凹陷,腰部凹陷的类圆柱体。结论设计胸腰椎单椎体内固定器械时应考虑到各椎体高度及矢状径、横径的大小不同。

Objective To provide the theory basis for the design of single vertebral internal fixation instrument for spine by measurement the height,sagittal diameter,transverse diameter of the Chinese vertebral body.Methods 50 cases of the healthy people of Chinese aged 18～60（average age 30.6±10.5） without lumbar spinal lesions were measured thoracolumbar body height,the upper,the middle,the lower sagittal diameter and transverse diameter by CT scan.Results The thoracolumbar body height became gradual increase from T11～L4.The middle height was lower than the anterior and the posterior height.The middle height ranges were 20.45～25.55mm（F：19.77～25.30mm）,21.24～27.41mm（F：20.84～26.22mm） for the anterior height,22.60～26.76mm（F：21.68～26.14mm）for the posterior height.The sagittal diameter and the transverse diameter were gradual increase from T11～L4.Compared with the middle,the upper and the lower of the sagittal diameter and transverse diameter had significant differences（P〈0.05）,the middle was minimum.Its range was from 28.56～33.36mm（F：27.63～31.42mm）,32.71～46.57mm（F：31.68～44.83mm）.The sagittal diameter of the upper was 30.67～37.71mm（F：29.23～36.51mm） and the transverse diameter of the upper was 36.85～51.81mm（F：34.81～48.89mm）.The sagittal diameter of the lower was 32.24～39.31mm（F：31.14～37.99mm）and the transverse diameter of the lower was 38.97～52.94mm（F：37.88～50.80mm）.Generally,the vertebral body was sunk columned in the upper and the lower and the middle by the overall view.Conclusion This study supplies the basis for the design single vertebral internal fixation instrument.Design devices should consider each vertebral the middle height,the sagittal diameter and the transverse diameter.