合并腰骶移行椎时应用骶髂螺钉的临床解剖测量

柳伟, 杜心如, 杨立辉, 王瑞, 张继宗, 孔晓川, 安立琨

中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (5) : 520-523.

中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (5) : 520-523.
应用解剖

合并腰骶移行椎时应用骶髂螺钉的临床解剖测量

  • 柳 伟1, 杜心如1, 杨立辉1, 王 瑞1, 张继宗2, 孔晓川1, 安立琨1
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The treatment of lumbosacral transitional vertebra using sacroiliac screws: clinical anatomic survey

  • LIU Wei1,DU Xin-ru1, YANG Li-hui1, WANG Rui1, ZHANG Ji-zong2, KONG Xiao-chuan1, AN Li-kun1
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摘要

目的 探讨合并腰骶移行椎时骶1、2椎弓根的形态学特点,为应用骶髂螺钉固定提供形态学基础。  方法 选取生前资料完整的标本共79例。对骶1、骶2椎体前后径、椎体高度、椎体横径、椎弓根前高、椎弓根后高、椎弓根宽度、进针深度、进针角度进行测量。  结果 正常骶1椎弓根前高(18.1±  3.8)mm,后高(20.6±3.6)mm,宽度(27.7±3.1)mm;Ⅱ型骶1椎弓根前高(19.9±2.0)mm,后高(19.2±2.6)mm,宽度(29.9±2.2)mm;Ⅲ型骶1椎弓根前高(18.5±3.0)mm,后高(16.9±3.1)mm,宽度(27.8±2.2)mm。正常骶2椎弓根前高(12.4±2.3)mm,后高(14.34±2.9)mm,宽度(22.2±3.1)mm,Ⅱ型骶2椎弓根前高(10.4±1.5)mm,后高 (14.4±2.4)mm,宽度(19.5±2.7)mm;Ⅲ型骶2椎弓根前高(9.5±2.0)mm,后高(14.0±3.0)mm,宽度(18.6±3.4) mm。Ⅱ型骶1椎弓根大于正常,Ⅲ型与正常接近。正常骶2椎弓根大于Ⅱ型和Ⅲ型。  结论 合并腰骶移行椎时可应用骶髂螺钉固定,骶1椎弓根可容纳1~2枚螺钉,骶2椎弓根可容纳1枚螺钉。

Abstract

Objective To study morphologic characteristics of S1 and S2 pedicles of sacrum co-existing lumbosacral transitional vertebra, and provide anatomic basis for sacroiliac screw fixation. Methods 79 specimens were selected and measured in this study. Anatomic measurements included the anteroposterior diameter of S1, the height and transverse diameter of S1 and S2, the anterior and posterior heights of S1and S2 pedicles, the width of S1 and S2 pedicles, and the depth and the angle of screw in S1 and S2. Results For normal specimens, anterior heights of S1 and S2 pedicles were about (18.1±3.8)mm and (12.4±2.3)mm,the posterior heights (20.6±3.6)mm and (14.34±2.9)mm, the width (27.7±3.1)mm and (22.2±3.1)mm;For typeⅡ specimens, anterior heights of S1 and S2 pedicles were about (19.9±2.0)mm and (10.4±1.5)mm,the posterior heights (19.2±2.6)mm and (14.4±2.4)mm,the width (29.9±2.2)mm and (19.5±2.7)mm;For type Ⅲ specimens, anterior heights (18.5±3.0)mm and (9.5±2.0)mm,the postreior heights (16.9±3.1)mm and (14.0±3.0)mm,the width (27.8±2.2)mm and (18.6±3.4)mm respectively. The size of normal S1 pedicle was less than type Ⅱ,however, that of type Ⅲ was similar to the normal. The size of normal S2 pedicle exceeded that of type Ⅱ and type Ⅲ. Conclusions sacroiliac screws fixation is reliable for treating lumbosacral transitional vertebre. One or two screws can be hold in S1 pedicle, however, only one screw can be hold in S2 pedicle.

关键词

腰骶移行椎 / 骶髂螺钉 / 椎弓根 / 骶骨

Key words

Lumbosacral transitional vertebre / Sacroiliac screws / Pedicle / Sacrum

引用本文

导出引用
柳伟, 杜心如, 杨立辉, 王瑞, 张继宗, 孔晓川, 安立琨. 合并腰骶移行椎时应用骶髂螺钉的临床解剖测量[J]. 中国临床解剖学杂志. 2011, 29(5): 520-523
LIU Wei, DU Xin-Ru, YANG Li-Hui, WANG Rui, ZHANG Ji-Zong, KONG Xiao-Chuan, AN Li-Kun. The treatment of lumbosacral transitional vertebra using sacroiliac screws: clinical anatomic survey[J]. Chinese Journal of Clinical Anatomy. 2011, 29(5): 520-523
中图分类号: R323.43,R682.13   

参考文献


[1]  杨开舜, 马梦昆, 劳汉昌. 骶髂螺钉固定在骶髂关节脱位中的应用解剖学研究
[J].中国矫形外科杂志, 2004 , 12 (11) : 848-850.

[2]  潘志军, 洪华兴, 黄宗坚,等. 骶髂关节螺钉固定的钉道参数应用解剖学研究
[J].中国临床解剖学杂志, 2004 , 22 (2) : 125-128.

[3]阮默, 徐达传, 汪新民,等. 经皮骶髂螺钉内固定术的应用解剖学研究
[J].中国临床解剖学杂志, 2006 , 24 (5) : 479-484.

[4]  张德春. 骶髂螺钉内固定术的临床应用解剖学及CT测量的实验研究
[D].济南:山东大学,2006.

[5]  乔国勇,张艳丽,田再杰,等. 骶骨螺钉固定骶髂关节钉道参数的变异性
[J].中国组织工程研究与临床康复,2008 ,12(52):10223-10226.

[6]  孔建中, 郭晓山, 潘骏,等. 经皮骶髂关节螺钉治疗骶骨纵形骨折
[J]. 中华创伤杂志, 2005 ,21,(6) : 410-412.

[7]  杜心如.腰骶移行椎临床解剖学研究进展
[J].中国临床解剖学杂志,2007,25(5):606-608.

[8]  Lee CH, Park CM, Kim KA, et al. Identification and p rediction of transitional vertebrae on imaging studies: anatomical significance of paraspinal structures
[J]. Clin Anat, 2007, 20 ( 8 ) :905-914.

[9] Castellvi AE , Goldstein LA , Chan DP. Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects
[J].Spine ,1984,9(5):493-495.

[10]  Mahato NK. Complete sacralization of L5 vertebrae: traits, dimensions, and load bearing in the involved sacra
[J].Spine, 2010,10(7): 610-615.

基金

北京市教委资助项目(KM200610025019);首都医科大学基础临床联合资助项目


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