椎弓根平面CT扫描数字解剖学技术在腰椎术前规划中的应用

发布时间：2018-04-30 08:30

本文选题：腰椎 + 骨钉　；参考：《中国组织工程研究》2017年19期

【摘要】：背景:椎弓根螺钉被广泛应用于脊柱内固定手术,与螺钉误置相关的并发症时有发生,常规影像学检查资料不能提供钉道的准确情况,椎弓根平面CT扫描则有助于直接观察椎弓根螺钉的钉道。目的:利用数字技术探讨椎弓根平面CT扫描在腰椎手术术前规划中应用价值。方法:在136例患者腰椎椎弓根平面CT图像上应用数字技术确定最佳置钉位置,测量可置入的椎弓根螺钉的长度、椎弓根最狭处宽度、椎弓根螺钉与标准矢状面和棘突的夹角,比较各测量值双侧差别,以及椎弓根螺钉与矢状面、棘突夹角的差别。结果与结论:(1)各腰椎的椎弓根螺钉长度双侧差异无显著性意义(P0.05);(2)L1和L4双侧椎弓根宽度差异有显著性意义(P0.05);(3)椎弓根与标准矢状面的夹角各腰椎左右两侧差异无显著性意义(P0.05);(4)椎弓根与棘突的夹角各腰椎左右两侧差异无显著性意义(P0.05);(5)综上,椎弓根平面CT扫描能准确反映患者椎弓根解剖情况,有助于术前规划,腰椎椎弓根解剖变异较大,置钉时应在良好的术前规划基础上充分考虑个体化因素。
[Abstract]:Background: pedicle screws are widely used in spinal internal fixation. Complications associated with screw misplacement occur from time to time. Conventional imaging data do not provide accurate information about the nail canal. Ct scan of pedicle plane is helpful to observe the nail path of pedicle screw directly. Objective: to evaluate the value of pedicle plane CT scan in preoperative planning of lumbar vertebrae operation by digital technique. Methods: digital technique was used to determine the optimal position of pedicle screw placement in 136 cases of lumbar pedicle CT images. The length, the narrowest width of pedicle screw, the angle between pedicle screw and standard sagittal plane and spinous process were measured. The bilateral differences between the measured values and the angle between pedicle screw and sagittal plane and spinous process were compared. Results and conclusion there was no significant difference in the length of pedicle screw between different lumbar vertebrae (P 0.05). There was significant difference in the width of pedicle between L _ 1 and L _ 4. There was no significant difference in the angle between pedicle and standard sagittal plane on the left and right sides of lumbar vertebrae. The angle between pedicle and spinous process had no significant difference between right and left lumbar vertebrae. Ct scan of pedicle plane can accurately reflect the anatomical situation of the pedicle of the patients, which is helpful to preoperative planning. The anatomical variation of the pedicle of the lumbar vertebrae is large, and individualized factors should be fully considered on the basis of good preoperative planning when the screw is placed.
【作者单位】：解放军第202医院骨科;
【基金】：辽宁省自然科学基金计划面上项目(201602746)~~
【分类号】：R687.3;R816.8

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