Kömürcü Erkam, Kaymaz Burak, Adam Gürhan, Gölge Umut Hatay, Göksel Ferdi, Özden Raif
Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Orthopedics and Traumatology, Çanakkale, Turkey.
Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Radiology, Çanakkale, Turkey.
Acta Orthop Traumatol Turc. 2015;49(5):522-9. doi: 10.3944/AOTT.2015.14.0201.
The use of intralaminar screws (ILS) in spinal surgery has experienced a recent increase in popularity. The aim of this study is to define the morphological parameters of the lumbar laminas so that guidance may be defined for ILS placement.
The study involved the evaluation of lumbar computed tomography (CT) images of patients. Two hundred thirty-five patients (127 male, 108 female) were included in the study. The mean patient age was 44.2 years (19-78 years). The measured parameters of the lamina were the transverse inner diameter, transverse outer diameter (lamina width), lamina length, subdural space (safe zone), and spinolaminar angle for each lumbar level (L1-L5).
The mean transverse outer diameter (L1-L5) ranged from 7.2-7.8 mm, and mean transverse inner diameter ranged from 2.5-3.0 mm. The lamina of L3 had the largest width and the lamina of L1 and L5 the smallest. The mean lamina length was 26.6 mm, ranging from 21.0-34.0 mm, and the mean spinolaminar angle was 124.7°, ranging from 111-135°. The L1 level had the shortest mean lamina length and L4 the lowest spinolaminar angle. Mean subdural space (safe zone), which was narrowest at the L5 level, was 2.4 mm, ranging from 1.3-3.6 mm.
ILS of the appropriate size (3.5-4.5 mm) and length (20 and 25 mm) can be used safely in the lumbar spine. However, further biomechanical studies should be performed to measure strength of the fixation.
椎板内螺钉（ILS）在脊柱手术中的应用近来越来越普遍。本研究的目的是确定腰椎椎板的形态学参数，以便为ILS置入制定指导原则。
本研究涉及对患者腰椎计算机断层扫描（CT）图像的评估。235例患者（男127例，女108例）纳入研究。患者平均年龄为44.2岁（19 - 78岁）。测量的椎板参数包括每个腰椎节段（L1 - L5）的横向内径、横向外径（椎板宽度）、椎板长度、硬膜下间隙（安全区）和棘突椎板角。
平均横向外径（L1 - L5）范围为7.2 - 7.8 mm，平均横向内径范围为2.5 - 3.0 mm。L3椎板宽度最大，L1和L5椎板宽度最小。平均椎板长度为26.6 mm，范围为21.0 - 34.0 mm，平均棘突椎板角为124.7°，范围为111 - 135°。L1节段平均椎板长度最短，L4节段棘突椎板角最低。平均硬膜下间隙（安全区）在L5节段最窄，为2.4 mm，范围为1.3 - 3.6 mm。
合适尺寸（3.5 - 4.5 mm）和长度（20和25 mm）的ILS可安全用于腰椎。然而，应进行进一步的生物力学研究以测量固定强度。
