数字化虚拟骶骨置钉的解剖学测量

Anatomical measurement of the sacral nailing by digital virtual technology

背景:骶骨由于处在脊柱与骨盆的交界区,其骨折极易漏诊。骶骨骨折的漏诊和治疗不当会造成进一步的神经损伤和后期的腰骶部畸形,其矫形手术困难,且疗效亦不如新鲜骨折。因此,早期诊断治疗骶骨骨折十分重要。目的:利用数字化虚拟技术进行骶骨部分置钉点的数字解剖研究,为临床治疗及内固定的进一步研究提供参考。方法:选取60例成人骨盆CT扫描数据,男女比为1∶1,利用Mimics 16.0软件进行三维模型重建,选择拟进行测量的点,然后分别在水平面、矢状面进行相关数据的测量。结果与结论:(1)L5关节突下缘与S1骶后孔上缘连线的中点允许置钉;(2)每侧上一骶后孔下缘与下一骶后孔上缘连线的中点,即众多学者描述的椎弓根置钉点同样允许置钉;(3)其余测量指标差异均无显著性意义(P>0.05);(4)结果表明,利用数字化模拟技术对骶骨各置钉点进行数据测量,所得出的各置钉点允许置钉的深度及角度可作为临床治疗骶骨骨折的参考依据。

BACKGROUND:The surgeons are prone to leak a sacral fracture because of its junction with the spine and pelvis.Misdiagnosis and improper treatment of sacral fracture can cause further nerve injury and later lumbar sacral deformity,and its orthopedic operation is difficult and the curative effect is not as good as fresh fracture.Thereafter,early diagnosis and treatment of sacral fracture are very important.OBJECTIVE:To carry out digital anatomic study of sacral part placement points using digital virtual technology,so as to provide guidance for clinical treatment.METHODS:Sixty cases of adult pelvis CT scan(the ratio of men and women was 1:1)were selected randomly.The three-dimensional model was reconstructed by Mimics 16.0 software,and the measured points were selected.Then the related data were measured on the horizontal and sagittal planes,separately.RESULTS AND CONCLUSION:(1)The midpoint of the interconnections between the lower edge of the L5 and the upper margin of the posterior sacral hole of the S1 was allowed.(2)The midpoint of the line between the lower margin of the sacral hole and the upper margin of the lower sacral posterior orifice,namely the pedicle point of the longitudinal multi scholar,allowed the nail to be placed equally.(3)The differences in the other measurements were insignificant(P>0.05).(4)To conclude,the digital simulation technique is used to measure the nail point of the sacrum,and the depth and angle of the nailed points of each point can be used as a reference for the treatment of sacral fracture.