de Peretti F, Argenson C, Bourgeon A, Omar F, Eude P, Aboulker C
Laboratoire d'Anatomie et Recherche Chirurgicale Expérimentale, Faculté de Médecine, Université de Nice Sophia-Antipolis, France.
Surg Radiol Anat. 1991;13(2):133-7. doi: 10.1007/BF01623887.
The authors present the anatomic and experimental basis of an original technique for screwing at the first sacral level employed in lumbosacral fusion. The anatomic studies were based on specimens from the anatomy museum, frozen sections of the sacrum and CT examinations with three-dimensional reconstruction and assessment of the density of the different structures of S1 in Hounsfield units (HU). The findings were that the ala and lateral portions of S1 contain yellow marrow forming what amounts to a fatty sphere bounded by the cortical bone of the sacroiliac joint, the linea terminalis and the spongy bone of the pedicles and of the body of S1. The experimental study was made by avulsion of sacral screws (system of Cotrel Dubousset), each of 7mm diameter. No screw perforated the sacral cortex. Three directions were tested. The insertion of a screw through the pedicle and body of S1 is advised, with the point of insertion below and lateral to the articular process of S1 and an oblique course forward and inward at an angle of 10 degrees to the sagittal plane. This internal obliquity is limited by the posterior prominence of the iliac ala.
作者介绍了一种用于腰骶融合的在第一骶骨水平进行螺钉固定的原创技术的解剖学和实验基础。解剖学研究基于解剖博物馆的标本、骶骨冷冻切片以及进行三维重建的CT检查，并以亨氏单位（HU）评估S1不同结构的密度。研究结果表明，S1的翼部和外侧部分含有黄骨髓，形成了一个由骶髂关节皮质骨、终线以及S1椎弓根和椎体的松质骨界定的脂肪球。实验研究通过拔出直径为7mm的骶骨螺钉（Cotrel Dubousset系统）进行。没有螺钉穿透骶骨皮质。测试了三个方向。建议通过S1的椎弓根和椎体插入螺钉，插入点位于S1关节突下方和外侧，并以与矢状面成10度角向前和向内的倾斜路径。这种向内的倾斜受到髂骨翼后突的限制。
