以棘突定位胸腰椎经椎弓根内固定的应用解剖学研究及意义

Applied Anatomic Study and Clinical Significance About Superior of Spinous Processes and to Pedicle of Vertebral Arch of the Thoracic and Lumbar Spine

目的 研究胸腰椎棘突与椎弓根的解剖关系,提供相关数据为椎弓根穿钉确定一种新的解剖定位点。方法 测量30具正常成人尸体的干燥胸腰椎标本,80个正常成人胸腰椎X线片及60人胸腰椎CT片(T_(10)～L_5节段)之棘突上缘根部至椎弓根上缘、下缘及中轴线的距离。用5具新鲜尸体做实验室手术模拟。结果 获得了相关解剖学数据,据所得数据设计螺钉入点。实验室80个螺钉全部穿钉成功,并成功临床应用6例。结论 该研究揭示了棘突与椎弓根的解剖关系,为经椎弓根手术提供了一种新的解剖学定位方法。

Objective To study the anatomic relationship between spinous processes and pedicle of vertebral arch about thoracic and lumbar spine, provide related data and to define a newly anatomic landmarks for placement of screw into pedicle. Methods Thirty dry abult skeletons and eighty abult pepole' s thoracic and lumbar plain radiographs and sixty abult people' s computer tomographic scans (T10 ~ L5 ) were obtained for study. The distance from superior of spinous processes pedicle to pedicle of vertebral arch superior, to inferior and to axis were measured. In laboratory five fresh cadavers were used to imitate operation. Results Obtained the related anatomic data and a screw projection point were all insered into pedicles successfully and six cases were used successfully in clinic. Conclusion This study gived the anatomic relationship between spinous processes and pedicle of vertebral arch, provided a newly anatomic localization approach for transpedicular operation.