膈肌脚的形态特点及其在胸腰椎爆裂骨折复位中的作用研究

doi:10.13418/j.issn.1001-165x.2015.05.003

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (5): 507-510.doi: 10.13418/j.issn.1001-165x.2015.05.003

膈肌脚的形态特点及其在胸腰椎爆裂骨折复位中的作用研究

姜良海¹，　杜心如¹，　孔祥玉²

1.北京朝阳医院骨科，北京 100020； 2.承德医学院解剖学教研室，河北承德 067000

收稿日期:2014-06-16 出版日期:2015-09-25 发布日期:2015-10-13
通讯作者: 杜心如，教授，硕士研究生导师，Tel:(010)85231703，E-mail：duxinru@163.com
作者简介:姜良海（1987-），男，山东临沂人，医学硕士，研究方向：脊柱外科，Tel:(010)85231227，E-mail：jianglianghai1988@163.com

The morphological features of diaphragmatic crura and their effect on the reduction of thoracolumbar burst fracture

JIANG Liang-hai¹, DU Xin-ru¹, KONG Xiang-yu²

1.Department of Orthopedics, Beijing Chaoyang Hospital, Beijing 100020, China; 2. Department of Anatomy, Chengde Medical College, Chengde, Hebei 067000, China

Received:2014-06-16 Online:2015-09-25 Published:2015-10-13

摘要/Abstract

摘要：

目的　探讨膈肌脚的形态特点及其在胸腰椎爆裂骨折复位中的作用。方法　成人胸腰段躯干标本3具，胸腰段横断面标本4套及矢状面标本1套，观察膈肌脚的形态及其与椎体、前纵韧带、椎间盘的附着关系。回顾性分析胸腰椎爆裂骨折患者资料64例（T12 12例，L1 31例，L2 14例，L3 7例），所有患者均行经伤椎椎弓根螺钉内固定，对比不同节段（T12、L1、L2、L3）手术前后伤椎Cobb角矫正量、前缘压缩率矫正量。结果　左、右膈肌脚位于T12~L4椎体前方为腱肌混合结构，与前纵韧带融合。伤椎Cobb角矫正量，T12为23.9±10.5°，L1 20.4±10.7°，L2 14.5±11.4°，L3 11.9±8.7°，T12与L2、L3相比，差异有统计学意义（P<0.05）。伤椎前缘压缩率矫正量，T12为0.48±0.13，L1 0.45±0.17，L2 0.37±0.20，L3 0.30±0.18，T12、L1与L3相比，差异有统计学意义（P<0.05）。结论　 T12、L1伤椎骨折复位率优于L2、L3，膈肌脚可能在胸腰椎爆裂骨折复位中起作用。

关键词: 膈肌脚, 胸椎, 腰椎, 骨折, 内固定

Abstract:

Objective　To study the morphological features of diaphragmatic crura and their effect on the reduction of thoracolumbar burst fracture. Methods Adult thoracolumbar segments of 3 specimens were anatomized. Sections of adult thoracolumbar segments were made in 5 specimens,4 in horizontal plane and 1 in sagittal plane. The clinical data of 64 patients with thoracolumbar burst fracturewere analyzed. The involved vertebrae included T12 (12 cases), L1 (31 cases), L2(14 cases), and L3 (7 cases). All patients underwent transvertebral pedicle screws internal fixation. The correction of compression rate and the Cobb angle of different segments were compared. Results The diaphragmatic crura were sturdy structure in front of T12~L4 vertebrae, which converged with the anterior longitudinal ligament in the end. The correction of Cobb angle of T12, L1, L2, and L3 injured vertebrae were 23.9±10.5°,20.4±10.7°,14.5±11.4°, and 11.9±8.7°, respectively. There was statistical significant difference among T12, L2 and L3（P<0.05）. The correction of compression rate of T12, L1, L2, and L3 were 0.48±0.13, 0.45±0.17, 0.37±0.20, and 0.30±0.18, respectively. There was statistical significant difference among T12, L1 and L3（P<0.05）. Conclusions After transvertebral pedicle screws internal fixation, the reduction of T12 and L1 vertebrae is better than L2 and L3 vertebrae. The diaphragmatic crura may have an important effect on the reduction of thoracolumbar burst fracture.

Key words: Diaphragmatic crura, Thoracic vertebrae, Lumbar vertebrae, Fractures, Fracture fixation

姜良海,杜心如,孔祥玉. 膈肌脚的形态特点及其在胸腰椎爆裂骨折复位中的作用研究[J]. 中国临床解剖学杂志, 2015, 33(5): 507-510.

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膈肌脚的形态特点及其在胸腰椎爆裂骨折复位中的作用研究

The morphological features of diaphragmatic crura and their effect on the reduction of thoracolumbar burst fracture

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