Service d'Orthopédie et Traumatologie de l'Hôpital Saint Roch, Nice, France.
Eur Spine J. 1992 Dec;1(3):170-7. doi: 10.1007/BF00301309.
Our aim was to determine the bone structure of the sacrum and the optimum location in the sacrum for the insertion of lumbosacral screws in osteosynthesis. Anatomical tests were performed on mortuary specimens at the Medical School in Nice, France, on frozen sections of sacrum and in computed tomographic (CT) sections with 3-dimensional reconstruction. Density assessment of different structures from the first and second sacral vertebrae (S1, S2) was performed and expressed in Hounsfield units. The ala and the lateral part of S1 contained yellow marrow forming a fatty mass bounded by the cortex of the sacroiliac joint at the linea terminalis and by the cancellous bone in the pedicles and the body of S1 and S2. These studies were undertaken prior to the experimental tests. The experimental tests were made using Cotrel-Dubousset instrumentation to determine the pull-out strength of sacral screws with a 7-mm diameter by assessing pull-out strengths of paired screws arranged either unilaterally with one screw in S1 and one in S2 or symmetrically to the left and right in S1. The devices demonstrating the best pull-out strength were the "corporopedicular" screw in S1 and the caudal lateral oblique screw in S1 passing through the sacroiliac joint. The paired screws with the best pull-out strength were those which included a corporopedicular screw in S1.
我们的目的是确定骶骨的骨结构以及在骶骨中进行腰骶螺钉固定的最佳位置。在法国尼斯医学院的尸体标本上进行了解剖学测试，对骶骨的冷冻切片和具有三维重建的计算机断层扫描（CT）切片进行了测试。从第一和第二骶骨（S1、S2）评估了不同结构的密度，并以亨氏单位表示。S1 的翼和外侧部分包含黄骨髓，形成脂肪块，由骶髂关节的终线处的皮质和 S1 和 S2 的椎弓根和体部的松质骨限制。这些研究是在实验测试之前进行的。使用 Cotrel-Dubousset 器械进行了实验测试，以确定直径为 7 毫米的骶骨螺钉的拔出强度，通过评估单侧排列的一对螺钉（一个在 S1 中，一个在 S2 中）或对称地排列在 S1 的左侧和右侧的螺钉的拔出强度来评估。显示出最佳拔出强度的装置是 S1 中的“corporopedicular”螺钉和穿过骶髂关节的 S1 中的尾侧斜向螺钉。具有最佳拔出强度的成对螺钉是包含 S1 中的 corporopedicular 螺钉的螺钉。
