骶骨形态变化对第3骶骨安全区影响的数字化分析

Digital Analysis on the Impact of Sacral Morphological Changes on the Third Sacral Safe Zone

目的量化畸形骶骨的骨性解剖结构,并通过数字化分析、测量正常及畸形成人第3骶骨横向骨性钉道存在的情况。方法收集2018年12月至2023年12月内蒙古医科大学附属医院910例健康成人志愿者资料,男399例,女511例;年龄18~80岁,平均(40.80±13.89)岁;均进行骨盆X线和CT检查。根据骨盆解剖结构分为正常骨盆组和畸形骨盆组,并在CT扫描中进行骶髂关节螺钉通道的冠状面宽度、水平面宽度以及矢状面安全区面积的测量。结果910例志愿者中畸形骶骨389例,骶骨畸形率42.75%。S 3水平面上钉道的平均宽度,畸形组为(10.35±1.92)mm,正常组为(7.06±1.02)mm;S 3冠状面上钉道的平均宽度,畸形组为(8.17±1.74)mm,正常组为(5.57±0.82)mm;S 3矢状面安全区的平均面积,畸形组为(129.68±7.46)mm 2,正常组为(91.17±4.17)mm 2。结论S 3存在横向骨性通道的可能性和安全区面积较S 1和S 2小。但相较于正常骶骨,畸形骶骨拥有通道的可能性大,通道面积也大,可更安全地容纳骶髂横向螺钉。

Objective We have quantified the skeletal anatomy of the sacrum with congenital curvature and analyzed its normal and malformed conditions using digital analysis and measurement of the transverse bony foramina in the third sacral vertebrae of adult humans.Methods Data was collected from 910 healthy adult volunteers at the First Affiliated Hospital of Inner Mongolia Medical University between December 2018 and December 2023.The participants included 399 males and 511 females aged 18~80 years,with an average age of(40.80±13.89)years.All individuals underwent pelvic X-rays and CT scans and were categorized into normal pelvis and abnormal pelvis groups based on their pelvic anatomy.Additionally,measurements of the transverse width,coronal width,and sagittal safety zone area in the CT scan were taken for the sacroiliac joint screw channel.Results Among the 910 volunteers,389 cases were identified as having a deformed sacrum,leading to a deformation rate of 42.75%.Moreover,in the abnormal group,the width at the level of the third sacrum was(10.35±1.92)millimeters on average,significantly higher than the normal group’s average of(7.06±1.02)millimeters.The average cross-sectional width in the longitudinal section for the abnormal group was(8.17±1.74)millimeters,while the normal group’s average was(5.57±0.82)millimeters.Additionally,the average area of the safety zone for the abnormal group was(129.68±7.46)square millimeters,larger than the normal group’s average of(91.17±4.17)square millimeters.Conclusion A lateral bony corridor is present in S 3,which has a smaller safe zone compared to S 1 and S 2.In contrast to a normal sacrum,a deformed sacrum provides a higher probability and a larger area for passage,enabling a safer insertion of lateral screws into the sacroiliac joint.