Background Previous clinical and basic research of axial lumbar interbody fusion （AxiaLIF） all focused on the L5/S1.However,there is no data on the feasibility of this approach for the fusion of both L4/5 and L5/S1....Background Previous clinical and basic research of axial lumbar interbody fusion （AxiaLIF） all focused on the L5/S1.However,there is no data on the feasibility of this approach for the fusion of both L4/5 and L5/S1.This study aimed to explore whether transsacral axial interbody fusion is a candidate for the fusion of both L4/5 and L5/S1.Methods The subjects （n=40） underwent lumbosacral magnetic resonance imaging （MRI）.The median sagittal MRI images were analyzed and five measurement markers were defined as follows：the center of the L4/5 disc （A）,the center of the L5/S1 disc （B）,the anterior margin of the S1/2 space （C）,the sacrococcygeal junction （D）,and the coccygeal tip （E）.The measurement markers were connected each other to produce nine lines （AB,AC,AD,AE,BC,BD,BE,CD and CE） as the reference lines for surgical approaches.The distance between each reference line and the anterior and posterior margins of the L4,L5 and S1 vertebral bodies were measured to determine the safety of the respective approaches.Results Twenty subjects were capable of finding one reference line to fuse both L4/5 and L5/S1 via transsacral axial interbody fusion approach.The surgical approach reference line was AE or CE line.In the other 20 subjects,it was failed to find a reference line which met the safety criteria for fusing both L4/5 and L5/S1.Conclusions About half of subjects were capable of finding a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1.In some subjects,it was difficult to find a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1.展开更多
目的为腰骶椎轴向融合术入路提供解剖学基础。方法利用Mimics10.01对选取的CT数据进行三维重建,以STL格式导入Geomagic studio 12对三维模型进行简单优化,测量相关数据。结果以尾骨尖为切口,将轴向融合螺钉固定于腰骶椎体中轴的AxiaLIF...目的为腰骶椎轴向融合术入路提供解剖学基础。方法利用Mimics10.01对选取的CT数据进行三维重建,以STL格式导入Geomagic studio 12对三维模型进行简单优化,测量相关数据。结果以尾骨尖为切口,将轴向融合螺钉固定于腰骶椎体中轴的AxiaLIF手术方式,导针从尾骨尖到钉道入口的距离,男、女性分别为(101.7±9.5)mm,(100.2±9.0)mm(P>0.05);以尾骨切迹为切口,将轴向融合螺钉固定在腰骶椎中柱的AxiaLIF手术方式,导针从尾骨切迹到钉道入口的距离,男、女性分别为(82.4±9.5)mm,(83.1±10.6)mm(P>0.05);两种不同通路的AxiaLIF手术,导针到S3/4横线的垂直距离EF和EG,男性分别为(24.4±5.3)mm和(14.5±2.8)mm(P<0.05),女性分别为(27.0±5.6)mm和(17.0±3.8)mm(P<0.05),有显著的统计学差异。结论经尾骨尖为手术切口的AxiaLIF的危险度较高,以尾骨切迹为切口置钉于腰骶椎中柱的手术通路符合骶前间隙安全范围,有待进一步由生物力学研究验证。展开更多
文摘Background Previous clinical and basic research of axial lumbar interbody fusion （AxiaLIF） all focused on the L5/S1.However,there is no data on the feasibility of this approach for the fusion of both L4/5 and L5/S1.This study aimed to explore whether transsacral axial interbody fusion is a candidate for the fusion of both L4/5 and L5/S1.Methods The subjects （n=40） underwent lumbosacral magnetic resonance imaging （MRI）.The median sagittal MRI images were analyzed and five measurement markers were defined as follows：the center of the L4/5 disc （A）,the center of the L5/S1 disc （B）,the anterior margin of the S1/2 space （C）,the sacrococcygeal junction （D）,and the coccygeal tip （E）.The measurement markers were connected each other to produce nine lines （AB,AC,AD,AE,BC,BD,BE,CD and CE） as the reference lines for surgical approaches.The distance between each reference line and the anterior and posterior margins of the L4,L5 and S1 vertebral bodies were measured to determine the safety of the respective approaches.Results Twenty subjects were capable of finding one reference line to fuse both L4/5 and L5/S1 via transsacral axial interbody fusion approach.The surgical approach reference line was AE or CE line.In the other 20 subjects,it was failed to find a reference line which met the safety criteria for fusing both L4/5 and L5/S1.Conclusions About half of subjects were capable of finding a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1.In some subjects,it was difficult to find a suitable AxiaLIF reference line to fuse both L4/5 and L5/S1.
文摘目的为腰骶椎轴向融合术入路提供解剖学基础。方法利用Mimics10.01对选取的CT数据进行三维重建,以STL格式导入Geomagic studio 12对三维模型进行简单优化,测量相关数据。结果以尾骨尖为切口,将轴向融合螺钉固定于腰骶椎体中轴的AxiaLIF手术方式,导针从尾骨尖到钉道入口的距离,男、女性分别为(101.7±9.5)mm,(100.2±9.0)mm(P>0.05);以尾骨切迹为切口,将轴向融合螺钉固定在腰骶椎中柱的AxiaLIF手术方式,导针从尾骨切迹到钉道入口的距离,男、女性分别为(82.4±9.5)mm,(83.1±10.6)mm(P>0.05);两种不同通路的AxiaLIF手术,导针到S3/4横线的垂直距离EF和EG,男性分别为(24.4±5.3)mm和(14.5±2.8)mm(P<0.05),女性分别为(27.0±5.6)mm和(17.0±3.8)mm(P<0.05),有显著的统计学差异。结论经尾骨尖为手术切口的AxiaLIF的危险度较高,以尾骨切迹为切口置钉于腰骶椎中柱的手术通路符合骶前间隙安全范围,有待进一步由生物力学研究验证。
