国人成人经第1及第2骶椎骶髂骨螺钉置钉钉道差异的CT测量

发布时间：2018-01-09 15:17

本文关键词：国人成人经第1及第2骶椎骶髂骨螺钉置钉钉道差异的CT测量　出处：《解放军医学院学报》2016年06期 　论文类型：期刊论文

【摘要】：目的对国人经第1第2骶椎骶髂(sacral alar-iliac,SAI)螺钉固定钉道各参数进行CT测量,比较S1AI和S2AI螺钉钉道解剖参数差异。方法随机选取2015年4-10月本院影像归档和通信系统中60例骨骼发育成熟且骨盆正常国人的三维计算机断层扫描(3DCT)重建数据进行分析。S1和S2骶髂骨螺钉钉道参数中最大长度和宽度的轨迹通过旋转并截取三维骨盆获得。对长度和角度参数进行评估和比较。结果 S1AI置钉较S2AI置钉尾向倾角大,男性平均增加约26°,女性平均增加约24°[男性S1(57.25±4.37)°vs S2(31.02±7.43)°,女性S1(58.61±5.11)°vs S2(34.16±6.02)°;P0.05];外倾稍小,男性、女性皆平均减少2°[男性S1(38.14±3.10)°vs S2(40.25±2.84)°,女性S1(37.24±2.96°)vs S2(39.25±2.64°);P0.05];最长钉道长度:男性S1(119.46±3.77)mm vs S2(120.04±6.52)mm(P=0.551),女性S1(108.21±5.24)mm vs S2(109.47±4.63)mm(P=0.434);骶骨内钉道长度:男性S1(43.12±4.63)mm vs S2(35.75±5.03)mm(P0.05),女性S1(39.73±5.85)mm vs S2(32.16±5.28)mm(P0.05);髂骨内宽度:男性S1(22.05±4.91)mm vs S2(21.49±3.22)mm(P=0.672),女性S1(16.93±2.12)mm vs S2(15.35±2.71)mm(P=0.366);骨皮质距离:男性S1(9.42±2.41)mm vs S2(9.01±2.33)mm(P=0.352),女性S1(5.92±1.48)mm vs S2(6.34±1.26)mm(P=0.837)。S1AI与S2AI的入钉点比较,距皮肤距离、距中线距离、距髂后上棘距离均有统计学差异。结论国人成人骨盆存在最佳骶髂骨螺钉置钉钉道时,S1AI及S2AI螺钉均具有可行性。S1AI螺钉较S2AI螺钉置钉角度尾向倾角男性平均增加约26°,女性平均增加约24°,外倾稍小,男性女性皆平均减少2°,最长置钉长度基本相同,S1AI的入钉点距皮肤和髂后上棘更深,距中线稍远。临床操作中应注意S1和S2骶髂骨螺钉置钉角度、钉道长度及入钉点的差异。
[Abstract]:Objective to measure the parameters of sacral iliacus sacral sai screw fixation through sacral iliac canal of the first and second sacral vertebrae in Chinese. The anatomical parameters of S1AI and S2AI screws were compared. Methods 60 patients with mature bone and normal pelvis from April to October in our hospital from April to October of 2015 were selected randomly. Computed tomography (. 3DCT). The length and width of the maximum length and width of the suture parameters of the sacral iliac screw were analyzed by the reconstruction data. The length and angle parameters were evaluated and compared by rotation and amputation of the three-dimensional pelvis. The tail inclination angle of S1AI nail was larger than that of S2AI pin. The average increase is about 26 掳for men and 24 掳for women. [In males, S1 was 57.25 卤4.37 掳vs S2P 31.02 卤7.43 掳. In females, S1 was 58.61 卤5.11 掳vs S2P 34.16 卤6.02 掳; P0.05]; The extroversion is slightly smaller, with an average decrease of 2 掳for both males and females. [Male patients with S1T 38.14 卤3.10 掳vs S2N 40.25 卤2.84 掳. Female S1V 37.24 卤2.96 掳vs S2P 39.25 卤2.64 掳; P0.05]; The longest length of the nail canal was 119.46 卤3.77 mm in males vs 120.04 卤6.52 mm in males. Female S1: 108.21 卤5.24mm vs S2P 109.47 卤4.63mm, P = 0.434; The length of the internal sacral canal was 43.12 卤4.63 mm in males vs 35.75 卤5.03 mm in males (P 0.05). In females, S1 was 39.73 卤5.85mm vs S2C32.16 卤5.28mm P0.05A; The width of iliac bone was 22.05 卤4.91mm in males vs 21.49 卤3.22mm in males. In females, S1 was 16.93 卤2.12mm vs S2P was 15.35 卤2.71MMP 0.366m. The distance of bone cortex was 9.42 卤2.41mm in males vs 9.01 卤2.33mm in males (P < 0.352). The distance from the skin to the insertion point of S1C was 5.92 卤1.48mm vs 6.34 卤1.26mm / s, compared with that of S2AI (P < 0. 837) / S2AI (P = 0. 837). The distance from the middle line to the middle line and the distance from the posterior superior iliac spine were statistically different. Conclusion the optimal sacral iliac screw nail passage exists in the pelvis of Chinese adults. Both S1AI and S2AI screws were feasible. Compared with S2AI screws, S1AI screws increased by 26 掳in male and 24 掳in females, and slightly tilted out slightly. The average reduction of male and female was 2 掳, and the length of the longest insertion nail was almost the same as that of S1AI. The insertion point of the nail was deeper than that of the skin and the posterior superior iliac spine. We should pay attention to the angle, length and point of screw insertion of S1 and S2 sacral iliac screws.
【作者单位】：解放军总医院骨科;
【分类号】：R68;R816.8
【正文快照】： 骶骨骨盆后路固定技术在平背综合征、脊柱后凸畸形、骨盆倾斜、高度椎体滑脱、骨盆肿瘤等手术治疗中应用广泛。但因骨盆形态不规则且骶骨骨质多为骨松质,骶骨骨盆后路固定技术始终具有挑战性和争议性[1-6]。目前,最为常用的骶骨骨盆后路固定技术是Galveston技术及髂骨螺钉固定

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