胸腰椎椎弓根内径的测量及其临床意义

Measurement of the inner-diameter of pedicle in thoracolumbar spine and its clinical significance

目的 :为选择合适直径的椎弓根螺钉提供客观依据。方法 :在 5 0具脊柱标本上对T11～L5椎弓根的形态及其内纵径、横径进行了观察。结果 :T11～L3椎弓根横断面呈椭圆形 ,L4为近圆形或近方形 ,L5为扁椭圆形。椎弓根内纵径T1112 3± 1 3mm ,T12 12 0± 1 6mm ,L111 2± 1 7mm ,L2 10 1± 1 8mm ,L310 0± 2 0mm ,L49 3±1 5mm ,L5 9 4± 1 6mm。内横径T115 4± 0 9mm ,T12 5 5± 1 1mm ,L15 3± 1 1mm ,L2 5 4± 1 6mm ,L36 8± 1 7mm ,L48 5± 1 7mm ,L5 13 0± 2 4mm。内横径小于 4mm者T115 3% ,T12 15 % ,L12 5 9% ,L2 30 3% ,L38 1% ,L42 6 %。结论 :部分T11～L4椎弓根内横径过小 (≤ 4mm ) ,不宜选择做椎弓根螺钉内固定。

Objective:to measure the inner diameter of pedicle in thoracolumbar spine for selection of the proper screw.Method:The inner diameter of pedicle in thoracolumbar spine were measured in 50 specimens.Result:The vertical inner diameter were T11 12 3±1 3mm,T12 12 0±1 6mm,L1 1 2±1 7mm,L2 10 1±1 8mm,L3 10 0±2 0mm,L4 9 3±1 5mm,L5 9 4±1 6mm;the horizontal one were T11 5 4±0 9mm,T12 5 5±1 1mm,L1 5 3±1 1mm,L2 5 4±1 6mm,L3 6 8±1 7mm,L4 8 5±1 7mm,L5 13 0±2 4mm;the appearance rate of specimens whose horizontal diameter less than 4mm was 5 3% in T11,15% in T12,25 9% in L1 30 3% in L2 8 1% in L3,and 2 6% in L4.Conclusion:The inner diameter of the pedicle of thoracolumbar spine(T11～L4 ) was too small to suit the pedicle screw fixation.It may be one cause of pedicle penetration in operation.