Robertson P A, Stewart N R
Department of Orthopaedic Surgery, Auckland Hospital, New Zealand.
Spine (Phila Pa 1976). 2000 Mar 15;25(6):709-15. doi: 10.1097/00007632-200003150-00010.
An anatomic and radiologic study of lumbar and lumbosacral pedicle anatomy.
To define the radiologic anatomy of the lumbar and first sacral pedicle in the coaxial projection.
Fluoroscopic assistance for pedicle screw placement requires radiologic landmarks. The radiologic landmarks have previously been assumed. Detailed study of the correlation between anatomy and radiology is required.
Lumbar vertebrae and sacra were marked with radiopaque material to demonstrate the pedicle cortical borders. The vertebrae were then imaged in the coaxial projection to determine the correlation between the pedicle cortex and the radiologic image. Pedicle dimensions were recorded.
Pedicle dimensions were consistent with known measurements, yet the long axis of the L4 and L5 pedicle ellipse was oblique to the vertical. Consequently, the minor diameter of the pedicle ellipse was considerably less than the measured pedicle width at L5. The radiologic pedicle image was consistently within the true pedicle cortex, by up to 3 mm, and probably represents the inner cortical border of the pedicle. The S1 pedicle has reliable anatomic landmarks, yet only the medial and superior borders were visualized.
The radiologic pedicle image in the lumbar and lumbosacral spine is a reliable guide to the true bony cortex of the pedicle. At S1 the pedicle image is less well correlated with the cortical borders of the pedicle, yet other reliable anatomic landmarks exist.
一项关于腰椎和腰骶椎椎弓根解剖结构的解剖学与放射学研究。
明确同轴投照下腰椎及第一骶椎椎弓根的放射学解剖结构。
椎弓根螺钉置入术中的透视辅助需要放射学标志。此前这些放射学标志是假定的。需要对解剖学与放射学之间的相关性进行详细研究。
用不透射线材料标记腰椎和骶骨，以显示椎弓根皮质边界。然后对椎体进行同轴投照成像，以确定椎弓根皮质与放射学图像之间的相关性。记录椎弓根尺寸。
椎弓根尺寸与已知测量值一致，但L4和L5椎弓根椭圆的长轴与垂直方向倾斜。因此，椎弓根椭圆的短径明显小于L5处测量的椎弓根宽度。放射学上的椎弓根图像始终位于真正的椎弓根皮质内，最多相差3毫米，可能代表椎弓根的内侧皮质边界。S1椎弓根有可靠的解剖学标志，但仅能看到内侧和上侧边界。
腰椎和腰骶椎脊柱的放射学椎弓根图像是椎弓根真正骨皮质的可靠导向。在S1处，椎弓根图像与椎弓根皮质边界的相关性较差，但存在其他可靠的解剖学标志。
