胸椎后路经关节螺钉固定的可行性研究
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徐荣明 XU Rong-ming 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics,Ningbo Sixth People's Hospital,Ningbo 315040,Zhejiang,China  
刘观燚 LIU Guan-yi 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics,Ningbo Sixth People's Hospital,Ningbo 315040,Zhejiang,China lgysimon@yahoo.com.cn 
赵红勇 ZHAO Hong-yong 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics,Ningbo Sixth People's Hospital,Ningbo 315040,Zhejiang,China  
马维虎 MA Wei-hu 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics,Ningbo Sixth People's Hospital,Ningbo 315040,Zhejiang,China  
孙韶华 SUN Shao-hua 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics,Ningbo Sixth People's Hospital,Ningbo 315040,Zhejiang,China  
朱彦召 ZHU Yan-zhao 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics,Ningbo Sixth People's Hospital,Ningbo 315040,Zhejiang,China  
许楠健 XU Nan-jian 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics,Ningbo Sixth People's Hospital,Ningbo 315040,Zhejiang,China  
林华杰 LIN Hua-jie 宁波市第六医院骨科,浙江 宁波 315040 Department of Orthopaedics,Ningbo Sixth People's Hospital,Ningbo 315040,Zhejiang,China  
期刊信息:《中国骨伤》2011年,第24卷,第3期,第218-221页
DOI:10.3969/j.issn.1003-0034.2011.03.012
基金项目:
中文摘要:

目的:明确胸椎后路经关节螺钉固定的解剖学可行性和技术参数,为临床应用提供参考。

方法:2009年9月至2009年12月,取20具胸椎标本,男12具,女8具,仔细解剖颈部的后侧和前侧方,以清楚地暴露胸椎椎板和椎弓根。以椎板下缘向上,外缘向内各7 mm为进钉点,在T1,2,T5,6,T9,10直视下置入经关节螺钉,通过CT重建,测量经关节螺钉内固定进钉角度和钉道长度。

结果:胸椎后路经关节螺钉均成功置入,螺钉固定方向在矢状面呈尾倾,冠状面呈外倾。经关节螺钉固定的平均角度在矢状面尾倾(52.6±5.9)°,在冠状面外倾(12.4±2.9)°。螺钉钉道长度(22.5±1.9) mm,各固定节段间角度略有不同,差异无统计学意义(P>0.5),但上、中、下不同胸椎节段之间的钉道长度差异有统计学意义(P<0.01).

结论:胸椎后路经关节螺钉具有解剖学可行性,可以作为胸椎椎弓根螺钉固定的一种补充内固定方法,但置钉时要求较高的准确性。
【关键词】胸椎  内固定器  解剖学  体层摄影术,X线计算机
 
Study on the feasibility of posterior thoracic transarticular screw fixation
ABSTRACT  

Objective: To study the feasibility and technical parameters of posterior transarticular screw fixation in the thoracic spine.

Methods: Since September 2009 to December 2009,20 thoracic cadaveric spines(12 males and 8 females) were dissected. The lateral masses and pedicles were exposed carefully. After the entrance point of transarticular screws was determined,posterior transarticular screws implantation was performed under direct visualization into T1,2,T5,6 and T9,10. Then CT scan was performed. On the CT scan,the angle and length of the transarticular screw trajectory were measured.

Results: The thoracic transarticular screw trajectory were caudal tilting in the sagittal plane and lateral tilting in the coronal plane with successful placement. There was little differences between different segmental of thoracic vertebrae of the angle,but without significance(P>0.5). The average angles of the screws were (52.6±5.9)° caudal tilting in the sagittal plane and (12.4±2.9)°lateral tilting in the coronal plane. The average trajectory lengths were (22.5±1.9) mm. There was significant differences statistically among T1,2,T5,6 and T9,10(P<0.01).

Conclusion: Posterior transarticular screw fixation is feasible. Transarticular screw fixation in the thoracic spine affords an alternative to standard pedicle screw placement for thoracic stabilization.
KEY WORDS  Thoracic vertebrae  Internal fixators  Anatomy  Tomography scanners,X-ray computed
 
引用本文,请按以下格式著录参考文献:
中文格式:徐荣明,刘观燚,赵红勇,马维虎,孙韶华,朱彦召,许楠健,林华杰.胸椎后路经关节螺钉固定的可行性研究[J].中国骨伤,2011,24(3):218~221
英文格式:XU Rong-ming,LIU Guan-yi,ZHAO Hong-yong,MA Wei-hu,SUN Shao-hua,ZHU Yan-zhao,XU Nan-jian,LIN Hua-jie.Study on the feasibility of posterior thoracic transarticular screw fixation[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(3):218~221
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