骨质疏松性椎体压缩骨折患者腰椎椎基静脉孔的CT影像解剖学研究

CT imaging anatomical study of lumbar vertebral basivertebral foramen in elderly patients with osteoporotic vertebral compression fractures

目的观察骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者腰椎椎基静脉孔(basivertebral foramen,BVF)形态学特征。方法选取腰椎OVCF患者107例,在CT三维重建图像上观察BVF数目和形态,测量BVF宽(basivertebral foramen width,BFW),深(basivertebral foramen depth,BFD),高(basivertebral foramen height,BFH),宽、深、高相对值(BFWr、BFDr、BFHr),距椎体左、右缘距离(left vertebral body width,VWL;right vertebral body width,VWR),距椎体上、下终板的距离(vertebral body up,VHU;vertebral body below,VHB)。用SPSS25.0软件进行分析。结果腰椎BVF多为单孔型,CT冠状面多呈矩形,横断面多呈三角形或梯形。平均BFW(7.8±1.6)mm,BFD(12.4±2.1)mm,BFH(5.4±1.1)mm。BVF平均宽、深、高分别占椎体同一平面宽、深、高的1/5、2/5、1/4。L_(1)、L_(3)VWL与VWR无统计学差异(P>0.05),L_(2)、L_(4)和L_(5)VWL与VWR有统计学差异(P<0.05)。VHU与VHB有统计学差异(P<0.05),BVF更靠近上终板。结论OVCF患者行骨水泥注射时,根据BVF解剖学特点确定穿刺靶点位置和骨水泥注入量,有利于预防骨水泥椎管内渗漏。

Objective To observe the morphological characteristics of basivertebral foramen(BVF)in patients with osteoporotic vertebral compression fracture(OVCF).Methods One hundred and seven cases of lumbar OVCF patients were studied.The number and morphology of BVF were observed on CT images.The basivertebral foramen width(BFW),basivertebral foramen depth(BFD),basivertebral foramen height(BFH),BFW relative value(BFWr),BFD relative value(BFDr),BFH relative value(BFHr),left vertebral body width(VWL),right vertebral body width(VWR),vertebral body up(VHU)and vertebral body below(VHB)were measured.All the data were analyzed by SPSS25.0 software.Results Most BVF were single-hole type,rectangular on coronal images and triangular or trapezoidal on horizontal images.The average width of BVF was(7.8±1.6)mm,average depth was(12.4±2.1)mm and average height was(5.4±1.1)mm.The average width,depth and height of BVF respectively accounted for 1/5,2/5 and 1/4 of the vertebral body width,depth and height.There was no statistical difference between VWL and VWR in L_(1) and L_(3)(P>0.05),but there were statistical differences between VWL and VWR in L_(2),L_(4) and L_(5)(P<0.05).There were statistical differences between VHU and VHB(P<0.05),and BVF was closer to the upper endplate.Conclusions The puncture target position and amount of bone cement are determined in surgery according to the morphological characteristics and anatomical data of BVF,which is beneficial for preventing bone cement leakage.