下位腰椎椎弓根内固定术的断层解剖与CT

Sectional anatomy and CT image of the internal fixation of pedicle of L4 and L5

目的:为临床腰椎弓根内固定术的开展提供断层解剖学基础与CT资料。方法:在50例（标本24,CT26）经L4、L5椎弓根层面上,观察确定进针点,并测量椎弓根厚度、进针角度和从进针点经椎弓根中心至椎体前缘的距离等数据。结果:L4、L5椎弓根厚度、进针角度。从进针点经椎弓根中心至椎体前缘的距离,平均分别为11.55、15.25mm;16.01°、18.55°;53.69、50.85mm。固定针直径、进针角度和进针深度,分别为:6.50～7.50、7.50～8.50mm;14.00°～20.00°、17.00～23.00°和32.50～39.00、29.25～35.75mm。结论:在L4、L5椎弓根层面上,以上关节突基部外侧缘为进针点较佳。

Objective: To provide sectional anatomical basis and CT image information of the internal fixation on lumbar spinal pedicle for the clinical treatment. Methods: The pedicle of vertebral arch of L4 and L5 were selected on serial transverse sections of 50 cases (24 adult cadaver, 26 adult CT scan) . The thicknesses of pedicles, the angles of entering needles and the distance of entering needle from the front to the back through the center of pedicle were observed and measured. Results: The average thickness of pedicle, the angle of entering needle and the distance from the entering point through pedicle center to anterior margin of vertebral body of the L4,L5 were 11. 55mm, 15. 25mm; 16.01°,18.55°; 53. 69mm, 50. 85 mm respectively. The diameter of fixation screw, the angle and the distance of entering needle of L4,L5 were 6.50-7.50 mm, 7.50-8.50 mm, 14.00°-20.00°,17.00°-23.00° and 32.50-39.00 mm, 29.25-35.75 mm. Conclusion: On the transverse sections through the pedicle of L4,L5, the entering point through lateral margin of the superior articular process basis was the best one.