单侧椎弓根外侧入路腰椎体成形术穿刺技术的解剖学研究

Anatomy study of unilateral extrapedicular percutaneous vertebroplasty for lumbar vertebral compression fractures

目的：在X线引导下找到腰椎体成形术骨性进针点及进针角度。方法测量成人腰椎标本10例（男5例，女5例），按照设定的穿刺轨道测量内倾角、上倾角及骨性通道长度，利用上述数据在标本上进行验证，判断穿刺角度的准确性。结果椎弓根外侧入路水平面上穿刺角度：第1腰椎椎体男女分别为（34.74°±4.7°，32.52°±2.5°），第2腰椎（33.78°±4.6°，31.01°±2.9°），第3腰椎（35.10°±5.2°，33.26°±3.6°），除第2腰椎外，男女比较差异未见统计学意义（P﹥0.05）；骨性通道距离为7.18～24.2 mm，从第1腰椎到第3腰椎逐渐增大，男女比较差异未见统计学意义（ P﹥0.05）。结论椎弓根外入路易达到目标点，安全性高，该技术便于掌握，值得推广。

objective To investigate the puncture angle and the puncture points under the guidance of x-ray. Methods Ten adults’lumbar vertebra specimens（ femal 5 cases,male 5 cases）Were studied. According to the designed approach,introversion angle,declination angle Were measured on specimens. Verify the technique after puncturation. Results Introversion angle of male and female Were l1（ 34. 74° ± 4. 7°, 32. 52 ° ± 2. 5 ° ）,l2（ 33. 78 ° ± 4. 6 ° ,31. 01 ° ± 2. 9°）,l3（35. 10° ± 5. 2°,33. 26° ± 3. 6°） respectively,except l2 ,there Was no significant differences in sexual contradistinction（ P﹥0. 05 ）. The distance from osseous puncture point to the lateral edge of the pedicle Was 7. 18-24. 2 mm getting longer from 11-l3 ,there Was no significant differences in sexual contradistinction（ P﹥0. 05 ）. Con-clusions According to the parameters,extrapedicular percutaneous vertebroplasty is a safe and effective choice. Radioanatomical landmarKs and introversion angles should be taKen into consideration strictly.