中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (48): 8966-8969.doi: 10.3969/j.issn.1673-8225.2010.48.010

• 骨科植入物 orthopedic implant • 上一篇    下一篇

单枚融合器行经椎间孔腰椎椎体间融合的解剖学观测

王兆杰，安荣泽，王克强，齐新文，俞华威   

  1. 遵义医学院第五附属(珠海)医院骨外科，广东省珠海市  519100
  • 出版日期:2010-11-26 发布日期:2010-11-26
  • 通讯作者: 安荣泽，主任医师，教授，硕士生导师，遵义医学院第五附属(珠海)医院骨外科，广东省珠海市 519100 wangzhaojie@sohu.com
  • 作者简介:王兆杰☆，男，1964年生，山东省淄博市人，汉族，2005年四川大学华西临床医学院毕业，博士，主任医师，硕士生导师，主要从事骨与关节损伤的修复及重建。 zhaojiewang@163.com
  • 基金资助:

    珠海市医学重点专科建设基金资助(珠卫[2008]80)。

Anatomical observation of transforaminal lumbar interbody fusion using single anatomical threaded cage insertion

Wang Zhao-jie, An Rong-ze, Wang Ke-qiang, Qi Xin-wen, Yu Hua-wei   

  1. Department of Orthopedics, Fifth Affiliated (Zhuhai) Hospital of Zunyi Medical College, Zhuhai  519100, Guangdong Province, China
  • Online:2010-11-26 Published:2010-11-26
  • Contact: An Rong-ze, Chief physician, Professor, Master’s supervisor, Department of Orthopedics, Fifth Affiliated (Zhuhai) Hospital of Zunyi Medical College, Zhuhai 519100, Guangdong Province, China wangzhaojie@sohu.com
  • About author:Wang Zhao-jie☆, Doctor, Chief physician, Master’s supervisor, Department of Orthopedics, Fifth Affiliated (Zhuhai) Hospital of Zunyi Medical College, Zhuhai 519100, Guangdong Province, China
  • Supported by:

    the Key Medical Construction Foundation of Zhuhai, No. [2008]80

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摘要：

背景：有部分学者认为，与经椎间孔腰椎椎体间融合技术相关的手术器械是按照西方人体格设计，和国人体格存在一定的差异，甚至融合物难以置入，所以探讨相关的解剖技术就显得很有必要。
目的：测量腰椎椎间孔及与经椎间孔腰椎椎体间融合相关的解剖参数。
方法：对14具正常成人尸体脊柱腰段椎间孔宽度、长度、高度进行了观测；对腰椎各结构与后正中矢状面的距离进行了观测。
结果与结论： 结果表明腰段(L1~ L5)椎间孔宽度逐渐变小；L1 ~ L4椎间孔高度逐渐增大，L5略小于L4，L1 ~ L5高度均明显大于其宽度(P < 0.01)；L1 ~ L5椎间孔长度逐渐增大(P < 0.05)。L1至L5 椎板峡部宽、下关节突最外侧缘至后正中矢状面距离逐渐增大，其性别间、左右间差异均无显著性意义(P > 0.05)。结果表明国人经椎间孔入路能满足高度9~14 mm单枚椎间融合器斜向置入，单枚椎间融合器置入不会因牵拉硬膜囊和神经根而导致脊髓与神经根损伤。

关键词: 椎间融合器, 经椎间孔腰椎椎间融合术, 腰椎椎间孔, 解剖参数, 尸体标本

Abstract:

BACKGROUND: The surgical instruments of transforaminal lumbar interbody fusion (TLIF) have been shown to be designed according to the body of the Western. Therefore, it is necessary to explore the related anatomy technique.
OBJECTIVE: To measure the lumbar intervertebral foramen and the anatomical data associated with TLIF.
METHODS: Intervertebral foramen width, length, and height of 14 normal adult cadavers lumbar spine were observed; the distance from structure of the lumbar spine to the midst sagittal plane from L3 to L5 was measured as well.
RESULTS AND CONCLUSION: Lumbar intervertebral foramen width gradually become smaller from L1 to L5; the height was gradually increased from L1 to L4, and L5 was slightly smaller than L4; the height was significantly greater than the width from L1 to L5 (P < 0.01); the length of intervertebral foramen was gradually increased from L1 to L5 as well (P < 0.05). The distance from the lateral margin of the pars interarticularis to the midst sagittal plane from L3 to L5 was gradually increased, and the distance from inferior articular process to the midst sagittal plane from L3 to L5 was increased as well. There was no significant difference in gender or two sides (P > 0.05). Results showed that 9-14 mm single posterolateral threaded fusion cage can be inserted by intervertebral foramen approach in Chinese. Single cage implant do not pull dura or nerve roots, thereby preventing spinal cord and nerve root injury.

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