S2横形螺钉固定变异骶骨Ⅲ区骨折的影像解剖学研究

发布时间：2018-04-02 12:17

  本文选题：骶骨　切入点：变异　出处：《中国临床解剖学杂志》2017年02期

【摘要】：目的探讨S_1椎不能横形置入骶髂螺钉固定骶骨Ⅲ区骨折时,置入S_2横形螺钉的安全参数。方法用Mimics软件对96例骨盆CT数据进行三维重建,模拟横形置入S_1、S_2螺钉,根据能否横形置入S_1螺钉将骶骨病例分为正常组与变异组。重建骨盆周围软组织,确定S_2横形螺钉进钉点B、髂前上棘顶点M、髂嵴上点N的体表投影点B_1、M_1、N_1,并测量各点间的长度。结果正常组男、女B_1M_1长度分别为(140.94±16.64)mm、(143.95±16.27)mm,均明显大于变异组男、女B_1M_1的长度(129.37±14.93)mm、(132.07±16.84)mm(P_男0.05,P_女0.05)。正常组与变异组B_1N_1的长度男性分别为(69.92±6.73)mm、(72.64±7.46)mm,女性分别为(60.80±7.05)mm、(58.85±7.81)mm,其差异均无统计学意义(P_男0.05,P_女0.05)。正常组与变异组M_1N_1的长度男性分别为(157.58±16.83)mm、(150.48±13.21)mm,女性分别为(156.79±15.84)mm、(151.49±16.58)mm,其差异均无统计学意义(P男0.05,P女0.05)。结论当S_1椎为腰骶移行椎、高位骶骨或骶骨翼斜坡陡峭变异时不能横形置入骶髂螺钉,可经S_2横形置入直径7.0 mm螺钉固定骶骨Ⅲ区骨折,术者在透视监视下可通过触摸髂前上棘及髂嵴来确定S_2螺钉的体表进钉点。
[Abstract]:Objective to investigate the safety parameters of S _ 2 transverse screw for the fixation of sacral fracture in the third area of sacral region. Methods 96 cases of pelvic CT data were reconstructed by Mimics software, and S1-S _ 2 screw was placed in the transverse shape. The sacrum cases were divided into normal group and variant group according to whether the S-1 screw could be inserted transversely. The soft tissue around the pelvis was reconstructed. The B_1M_1 length of the normal group was 140.94 卤16.64 卤16.27 卤143.95 卤16.27mm, respectively, and that of the body surface projection point of the anterior superior iliac spine and the suprailiac crest N was determined, and the length of each point was measured, and the length of the points between the two points was measured. The results showed that the length of the B_1M_1 in the normal group was 143.95 卤16.27 mm, which was significantly higher than that in the mutant group. The length of B_1N_1 in female B_1M_1 was 129.37 卤14.93mm, 132.07 卤16.84m, male 0.05p _ female, 69.92 卤6.73mm, 72.64 卤7.46mm, 60.80 卤7.05mm, 58.85 卤7.81mm, respectively. The length of M_1N_1 in normal group and variant group was 157.58 卤16.83mm, 150.48 卤13.21mm, respectively. The difference was not statistically significant. The length of M_1N_1 in normal group and mutated group was 157.58 卤16.83mm, 150.48 卤13.21mm, respectively. 156.79 卤15.84 卤151.49 卤16.58 mm, there was no significant difference between them. Conclusion when S1 vertebrae is lumbosacral transitional vertebra, there is no significant difference between them. Sacroiliac screws could not be inserted in high sacrum or sacral wing Clivus with steep variation. The sacral region 鈪，

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