Vaccaro A R, Rizzolo S J, Allardyce T J, Ramsey M, Salvo J, Balderston R A, Cotler J M
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
J Bone Joint Surg Am. 1995 Aug;77(8):1193-9. doi: 10.2106/00004623-199508000-00008.
We studied the morphology of the thoracic vertebrae in the spines of seventeen human cadavera in order to define parameters that could be used as guidelines for the placement of hooks and screws in the pedicles to obtain internal fixation. We also reviewed computerized tomographic scans of nineteen thoracic spines in living patients who had no evidence of any vertebral deformity. The transverse diameter of the pedicle, which helps to determine the size of the screw, ranged from a mean (and standard deviation) of 4.5 +/- 1.2 millimeters in the fourth thoracic vertebra to a mean of 7.8 +/- 2.0 millimeters in the twelfth thoracic vertebra. The pedicles were inclined anteromedially throughout the thoracic spine, and the angle ranged from 0.3 degree toward the midline in the twelfth thoracic vertebra to 13.9 degrees in the fourth thoracic vertebra. The morphometric data revealed wide variations in the dimensions of the pedicles, demonstrating the importance of accurate preoperative imaging with transaxial computerized tomographic scans to visualize the precise osseous margins and angles of insertion of the thoracic pedicles.
我们研究了17具人类尸体脊柱中胸椎的形态，以确定可作为椎弓根内钩和螺钉置入指导方针的参数，从而实现内固定。我们还回顾了19例无椎体畸形证据的活体患者胸椎的计算机断层扫描图像。有助于确定螺钉尺寸的椎弓根横径，从第四胸椎的平均（及标准差）4.5±1.2毫米到第十二胸椎的平均7.8±2.0毫米不等。整个胸椎的椎弓根均向前内侧倾斜，角度范围从第十二胸椎向中线倾斜0.3度到第四胸椎的13.9度。形态学测量数据显示椎弓根尺寸存在很大差异，这表明术前通过经轴计算机断层扫描进行精确成像以可视化胸椎椎弓根的精确骨质边缘和置入角度非常重要。
