Kadioglu H H, Takci E, Levent A, Arik M, Aydin I H
Department of Neurosurgery, Research Hospital, Atatürk University Medical School, 25240 Erzurum, Turkey.
Surg Radiol Anat. 2003 May;25(2):120-6. doi: 10.1007/s00276-003-0109-y. Epub 2003 May 14.
Pedicle screw fixation of the spine has become one of the most stable and versatile methods of spine fixation, and knowledge of pedicle morphology is crucial for the safe application of these systems. We undertook this study because only a few reports have investigated Eastern populations. Lumbar pedicle anatomy, i.e., pedicle width (PW) and pedicle height (PH), transverse and sagittal pedicle angles (TPA, SPA), and pedicle length (PL), were assessed in the following two groups: (1) computed tomography scans of 29 normal adults, and (2) 16 dried lumbar spines obtained from the Anatomy Department. Interpedicular distance was different in each group. PW ranged from 4 mm to 14 mm. In both groups, the narrowest PH was 8.2 mm, the widest 19.7 mm. TPA ranged from 6(o) to 19(o) and increased from L1 to L5. In the sagittal plane, the pedicles angled caudally at L5. PL was longest at L1 and shortest at L5. In conclusion, pedicle dimensions and angles may show individual and structural differences. Our data were not significantly different from previous reported data. A detailed knowledge of these relationships is important for any surgery involving screw purchase via a pedicle, to prevent screw cutout and failure of fixation or neurological injury. Selection of the proper diameter of screw is an important issue for safe placement. Knowledge of the pedicle axis length is essential in choosing screw lengths but should always be checked intraoperatively with fluoroscopic control during screw insertion.
脊柱椎弓根螺钉固定术已成为最稳定、用途最广泛的脊柱固定方法之一,了解椎弓根形态对于这些系统的安全应用至关重要。我们开展这项研究是因为仅有少数报告对东方人群进行过调查。对以下两组人群的腰椎椎弓根解剖结构进行了评估,即椎弓根宽度(PW)、椎弓根高度(PH)、横位和矢状位椎弓根角度(TPA、SPA)以及椎弓根长度(PL):(1)29名正常成年人的计算机断层扫描;(2)从解剖学系获取的16具干燥腰椎标本。两组的椎弓根间距有所不同。PW范围为4毫米至14毫米。在两组中,最窄的PH为8.2毫米,最宽的为19.7毫米。TPA范围为6°至19°,并从L1至L5逐渐增大。在矢状面上,L5处的椎弓根向尾侧倾斜。PL在L1处最长,在L5处最短。总之,椎弓根尺寸和角度可能存在个体差异和结构差异。我们的数据与先前报道的数据无显著差异。对于任何涉及通过椎弓根置入螺钉的手术,详细了解这些关系对于防止螺钉穿出、固定失败或神经损伤都很重要。选择合适的螺钉直径是安全置入的重要问题。了解椎弓根轴线长度对于选择螺钉长度至关重要,但在螺钉置入过程中应始终通过术中透视控制进行检查。