中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (39): 7242-7245.doi: 10.3969/j.issn.2095-4344.2012.39.005

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

以棘突连线确定矢状面进钉角度在胸腰椎内固定治疗中的应用

陈卫东，杨庆国，张银顺，刘金锐，薄 冉   

  1. 安徽医科大学第一附属医院骨三科，安徽省合肥市 230001
  • 收稿日期:2012-01-20 修回日期:2012-02-27 出版日期:2012-09-23 发布日期:2012-09-23
  • 通讯作者: 杨庆国，教授，主任医师，硕士生导师，安徽医科大学第一附属医院脊柱外科，安徽省合肥市 230022 yqgyly@126.com
  • 作者简介:陈卫东★，男，1980年生，安徽省安庆市人，汉族，安徽医科大学在读硕士，主治医师，主要从事脊柱骨科研究。 cwd1980@sina.com.cn

Application of sagittal screw angle based on supraspinous line in the treatment of thoracolumbar fixation

Chen Wei-dong, Yang Qing-guo, Zhang Yin-shun, Liu Jin-rui, Bo Ran   

  1. Third Department of Orthopedics, First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
  • Received:2012-01-20 Revised:2012-02-27 Online:2012-09-23 Published:2012-09-23
  • Contact: Yang Qing-guo, Professor, Chief physician, Master’s supervisor, Third Department of Orthopedics, First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China yqgyly@126.com
  • About author:Chen Wei-dong★, Studying for master’s degree, Attending physician, Third Department of Orthopedics, First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China cwd1980@sina.com.cn

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670

被引次数

1

摘要：

背景：理想的胸腰段骨折复位需要准确的椎弓根钉置入角度以达到理想的应力作用，近年来国内外有很多专家学者设计了多种方法，基本以椎体或附件本身的解剖结构设计某一平面作为参考，精确程度不一。
目的：选择棘突连线作为胸腰段骨折内固定手术中椎弓根螺钉与终板保持平行的参照并给出理论依据。
方法：选择49例正常胸腰段和21例胸腰段骨折(无棘突骨折)MRI片测量椎体上终板平行线与相应棘突连线的夹角，两者比较并进行统计学对比分析。
结果与结论：正常胸腰椎椎体上终板平行线与棘突连线夹角在T10-L3基本为90°，在L4处为82°左右，而椎体骨折后所测角度差别不大。结果提示在胸腰椎骨折内固定手术过程中，如果保持椎弓根螺钉与棘突连线夹角在T10-L3为90°，L4为80°左右，基本能够保证椎弓根螺钉与终板保持平行，将棘突连线作为螺钉置入的参考解剖标志在理论上是可行的。

关键词: 胸腰段骨折, 内固定, 矢状面, 棘突连线, 置钉角度, 胸腰椎, 植入体

Abstract:

BACKGROUND: Ideal reset of the thoracolumbar fractures needs accurate pedicle screw placement angle to achieve the desired stress. In recent years, a variety of means have designed by the experts and scholars at home or abroad, almost all the means are aimed to design a plane with the reference of the anatomical structure of vertebral body or attachments, so accurate degree is not uniform.
OBJECTIVE: To analyze whether supraspinous line can be the identification marker of the sagittal screw angle of the pedicle of vertebral arch in the thoracolumbar surgery．
METHODS: A total of 49 cases of the nomal thoracolumbar MRI images and 21 cases of T12 thoracolumbar fracture MRI images were included in the study to measure the angle of the vertebral body terminal plate parallel lines and the corresponding supraspinous lines. The comparison and statistical comparative analysis were performed.
RESULTS AND CONCLUSION: The angle of vertebral body terminal plate against supraspinous line was 90° at T10-L3, and was about 82° at L4. The angle was not changed before and after thoracolumbar fracture. In the internal fixation surgery of thoracolumbar fracture, if the angle of vertebral body terminal plate against supraspinous line is about 90° at T10-L3 and 80° at L4, the pedicle screw and terminal plate may be maintained in parallel basically. Supraspinous line can be the identification marker for sagittal screw angle of the pedicle of vertebral arch.

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