髂后上棘的解剖形态学分型及临床意义

doi:10.13418/j.issn.1001-165x.2022.4.01

中国临床解剖学杂志 ›› 2022, Vol. 40 ›› Issue (4): 377-382.doi: 10.13418/j.issn.1001-165x.2022.4.01

• 应用解剖 • 下一篇

髂后上棘的解剖形态学分型及临床意义

祁冀^1,2,3，李静²，王海洲¹，陈平¹，林定坤¹，陈海云¹，平瑞月²，徐燕笑⁴，李义凯⁵*

1.广东省中医院老年骨折科，广州 510120； 2.广州中医药大学第二临床医学院，广州 510006； 3.中国中医科学院望京医院，北京 100020； 4.苏州市永鼎医院，江苏苏州 215200； 5.南方医科大学南方医院中医正骨科，广州 510515

收稿日期:2020-11-09 出版日期:2022-07-25 发布日期:2022-07-25
通讯作者: 李义凯，教授，博士生导师，E-mail：lyksmu@126.com
作者简介:祁冀（1992-），男，山东威海人，博士，博士后，住院医师，研究方向：骨关节的基础和临床研究，E-mail：haoruiml@163.com
基金资助:
国家自然科学基金（81674095），广东省科技计划项目-海外名师专题（2020A1414010394），广东省基础与应用基础研究基金区域联合基金项目（20201910240000337）

Anatomical classification of posterior superior iliac spine and its clinical significance

Qi Ji^1,2,3, Li Jing², Wang Haizhou¹, Chen Ping¹, Lin Dingkun¹, Chen Haiyun¹, Ping Ruiyue², Xu Yanxiao⁴, Li Yikai⁵*

1.Department of Geriatric Fracture, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong Province, China; 2. The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China; 3. Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100020, China; 4. Suzhou Yongding Hospital, Suzhou 215200, Jiangsu Province, China; 5. Department of TCM Bone-Setting, Southern Medical University, Guangzhou 510515, Guangdong Province, China

Received:2020-11-09 Online:2022-07-25 Published:2022-07-25

摘要/Abstract

摘要： 目的研究髂后上棘的解剖学特征及其临床意义。方法选取280例干燥人体髋骨标本，以髂后上棘为A点，髂前上棘为B点，坐骨结节为C点，髂棘最高点为D点，耻骨结节为E点，耳状关节面后缘中点为F点，髂后上棘尖端A点的宽度为W0，A点的厚度为H0。髂嵴后部最大宽度为Wmax，其与A点的距离为D0，分别距离A点0.5、1.0、1.5、2.0 cm测量髂嵴的宽度，记为W1、W2、W3、W4，以髂嵴转折部为G点，G点宽度记为W5，分别测量AB，AC，AD，AE，AF，G，CD长度。结果髂后上棘形态大致分为4型：Ⅰ型“V”形（38.2%），Ⅱ型“U”形（43.2%），Ⅲ型“W”形（11.1%），Ⅳ型“增生型”（7.5%）。Ⅰ型的AB长度显著小于Ⅲ型和Ⅳ型，Ⅰ型的AF距离显著小于Ⅱ型和Ⅲ型，Ⅰ型的W0、W1、H0显著小于Ⅱ型、Ⅲ型、Ⅳ型，Ⅲ型的W0大于Ⅰ型Ⅱ型和Ⅳ型，均具有统计学意义（P<0.05）。结论髂后上棘有4种形态变异，以“U”形为主，具有一定的临床指导意义。

关键词: 髂后上棘； , , 解剖； , , 临床意义

Abstract: Objective To study the anatomical characteristics of posterior superior iliac spine and explore its clinical significance. Methods Two hundred and eighty dry hip specimens of humans were selected. The posterior superior iliac spine was point A, the anterior superior iliac spine was point B, the ischial tuberosity was point C, the highest point of the iliac spine was point D, the pubic tuberosity was point E, and the midpoint of the posterior edge of the articular surface was point F. The width of point A of the posterior superior iliac spine was W0, and the thickness of point A was H0. The maximum width of the posterior part of the iliac crest was Wmax, and the distance from point A to the posterior part of the iliac crest was D0. The width of the iliac crest was measured at 0.5 cm, 1.0 cm, 1.5 cm, and 2.0 cm from point A, which were recorded as W1, W2, W3, W4. The part of the iliac crest was taken as point G and the width of point G was denoted as W5. The lengths of AB, AC, AD, AE, AF, AG, and CD were measured, respectively. Results The morphology of the posterior superior iliac spine was roughly divided into the following 4 types: type I "V" (107 cases, accounting for 38.2%), type II "U" (121 cases, accounting for 43.2%), type III "W" (31 cases, accounting for 11.1%), type IV "Proliferative" (21 cases, accounting for 7.5%). The AB length of type Ⅰ was significantly shorter than that of type Ⅲ and Ⅳ, the AF distance of type Ⅰ was significantly shorter than that of type Ⅱ and Ⅲ. W0, W1 and H0 of type Ⅰ were significantly smaller than that of type Ⅱ, Ⅲ, and Ⅳ, and W0 of type Ⅲ was greater than that of type I, type II and type IV, all were statistically significant (P<0.05). Conclusions There are 4 morphological variations of the posterior superior iliac spine, with a "U" shape as the main one, which has of certain clinical implication.

Key words: Posterior superior iliac spine; , , Anatomy; , , Clinical significance

中图分类号:

R322.71

祁冀, 李静, 王海洲, 陈平, 林定坤, 陈海云, 平瑞月, 徐燕笑, 李义凯. 髂后上棘的解剖形态学分型及临床意义[J]. 中国临床解剖学杂志, 2022, 40(4): 377-382.

Qi Ji, Li Jing, Wang Haizhou, Chen Ping, Lin Dingkun, Chen Haiyun, Ping Ruiyue, Xu Yanxiao, Li Yikai. Anatomical classification of posterior superior iliac spine and its clinical significance[J]. Chinese Journal of Clinical Anatomy, 2022, 40(4): 377-382.

参考文献 20

[1]	钟世镇. 系统解剖学[M]. 北京: 高等教育出版社, 2003: 28-29.
[2]	McGaugh JM, Brismée JM, Dedrick GS, et al. Comparing the anatomical consistency of the posterior superior iliac spine to the iliac crest as reference landmarks for the lumbopelvic spine: a retrospective radiological study[J]. Clin Anat, 2007, 20(7): 819-825. DOI: 10.1002/ca.20531.
[3]	Murakami E, Kurosawa D, Aizawa T. Treatment strategy for sacroiliac joint-related pain at or around the posterior superior iliac spine[J]. Clin Neurol Neurosurg, 2018, 165(2): 43-46. DOI: 10.1016/j.clineuro.2017.12.017.
[4]	Cooperstein R, Hickey M. The reliability of palpating the posterior superior iliac spine: a systematic review[J]. J Can Chiropr Assoc, 2016, 60(1): 36-46. PMID: 27069265.
[5]	官大威. 法医学辞典[M]. 北京: 化学工业出版社, 2009: 101.
[6]	Bonczarowska JH, Bonicelli A, Papadomanolakis A, et al. The posterior portion of the ilium as a sex indicator: a validation study[J]. Forensic Sci Int, 2019,294(1): 216.e1-216.e6. DOI: 10.1016/j.forsciint. 2018. 10.031.
[7]	Rmoutilová R, Dupej J, Velemínská J, et al. Geometric morphometric and traditional methods for sex assessment using the posterior ilium[J]. Leg Med (Tokyo),2017,26(5):52-61. DOI: 10.1016/j.legalmed. 2017. 03. 004.
[8]	Xu R, Ebraheim NA, Yeasting RA, et al. Anatomic considerations for posterior iliac bone harvesting[J]. Spine (Phila Pa 1976), 1996, 21(9): 1017-1020. DOI: 10.1097/00007632-199605010-00004.
[9]	Ebraheim NA, Elgafy H, Xu R. Bone-graft harvesting from iliac and fibular donor sites: techniques and complications[J]. J Am Acad Orthop Surg, 2001, 9(3): 210-218. DOI: 10.5435/00124635-200105000-00007.
[10]	吴垠. 如何选择合适的骨髓穿刺部位[J]. 中国全科医学, 2013, 16(12): 1443-1444. DOI: 10.3969/j. ssn.1007-9572.2013.04.115.
[11]	Yi KH, Lee HJ, Lee JH, et al. Effective botulinum neurotoxin injection in treating iliopsoas spasticity[J]. Clin Anat, 2021, 34(3): 431-436. DOI: 10.1002/ca.23670.
[12]	Lin JD, Tan LA, Wei C, et al. The posterior superior iliac spine and sacral laminar slope: key anatomical landmarks for freehand S2-alar-iliac screw placement[J]. Neurosurg Spine, 2018, 29(4): 429-434. DOI: 10.3171/2018.3.SPINE171374.
[13]	Kim HW, Ko YJ, Rhee WI, et al. Interexaminer reliability and accuracy of posterior superior iliac spine and iliac crest palpation for spinal level estimations[J]. J Manipulative Physiol Ther, 2007, 30(5): 386-389. DOI: 10.1016/j.jmpt.2007.04.005.
[14]	Srivastava S, Kumar KUD, Mittal H, et al. Short-term effect of muscle energy technique and mechanical diagnosis and therapy in sacroiliac joint dysfunction: a pilot randomized clinical trial[J]. Bodyw Mov Ther, 2020, 24(3): 63-70. DOI: 10.1016/j.jbmt.2020.02.017.
[15]	Werner CM, Hoch A, Gautier L, et al. Distraction test of the posterior superior iliac spine (PSIS) in the diagnosis of sacroiliac joint arthropathy[J]. BMC Surg, 2013, 13: 52. DOI: 10.1186/1471-2482-13-52.
[16]	樊春洲. 骶髂关节错位的诊断与治疗[J]. 黑龙江医药, 1980, 11(3): 7-9.
[17]	王廷臣. 骶髂关节错位的理论思考[J]. 中国组织工程研究与临床康复,2008,12(11):2161-2163.DOI:10.3321/j.issn:673-8225.2008.11.042.
[18]	Edge-Hughes L. Hip and sacroiliac disease: selected disorders and their management with physical therapy[J]. Clin Tech Small Anim Pract, 2007, 22(4): 183-194. DOI: 10.1053/j.ctsap.2007.09.007.
[19]	唐承杰, 陈经勇, 陈如见, 等. 自体髂后上棘骨移植在全髋关节置换术后髋臼松动翻修术中的应用[J]. 四川医学, 2010, 31(10): 1495-1496, DOI: 10.3969/j.issn.1004-0501.2010.10.040.
[20]	Nishi K, Tsurumoto T, Okamoto K, et al. Three-dimensional morphological analysis of the human sacroiliac joint: influences on the degenerative changes of the auricular surfaces[J]. J Anat, 2018, 232(2): 238-249. DOI: 10.1111/joa.12765.

髂后上棘的解剖形态学分型及临床意义

Anatomical classification of posterior superior iliac spine and its clinical significance

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