改良Steffee钢板在腰骶椎内固定术中的应用解剖学

Applied anatomy of internal fixation of lumbosacral vertebrae with modified Steffee plate

目的：为改良Ｓｔｅｆｆｅｅ钢板在腰骶椎内固定术中的应用提供解剖学基础。方法：在８具成人尸体标本上摹拟Ｌ５脊椎滑脱的Ｓｔｅｆｆｅｅ手术治疗。在Ｌ４～Ｓ１脊椎上分别安放Ｓｔｅｆｆｅｅ钢板和改良Ｓｔｅｆｆｅｅ钢板，比较２种内固定器械固定位置的解剖差异，并对１５副腰骶椎干燥骨标本做了经椎弓根内固定相关的数据测量。结果：传统的Ｓｔｅｆｆｅｅ钢板固定Ｓ１椎弓根螺钉安放困难，且进入椎管的机会多，或者是上２枚螺钉易套入钢板槽孔，而下面的螺钉难以套入钢板槽孔。改良Ｓｔｅｆｆｅｅ钢板可克服上述弊端，更符合局部解剖形态要求。结论：改良Ｓｔｅｆｆｅｅ钢板有科学的形态学依据，可临床试用。

To provide anatomical basis for the application of modified Stefee plate in internal fixation of lumbosacral vertebrae. Methods: The Steffee operations of L5 spondylolisthesis were simulated in 8 adult cadavers. Steffee plate and modified Steffee plate were fixed respectively in L4- S1 vertebrac, and the difference of the two types of internal fixation apparatus were compared. Furthermore, datum about the internal fixation of vertebral pedicle was measured on 15 dry lumbosacral vertebra specimens. Results: While fixing S1 vertebral pedicle with traditional Steffee plate, screws were difficult to be fixed,and slipped into the spinal canal easily,or the upper 2 screws can be easily inserted into the hole of the plate, but the lower screws were difficult to be inserted into. Conclusion: Having scientific morphological basis, modified Steffee plate can be applied to clincal operation.