中国人腰椎椎弓根的测量：特别提及经椎弓根螺钉固定术

Measurement of Chinese lumbar pedicles: with special reference to transpedicular screw fixation.

作者信息

Chen I H, Hou C H, Huang C I, Lee L S

机构信息

Department of Neurosurgery, Taipei Municipal Chung-Hsiao Hospital, Taiwan, R.O.C.

出版信息

Zhonghua Yi Xue Za Zhi (Taipei). 1994 Jun;53(6):351-6.

PMID:8087710

Abstract

BACKGROUND

Thorough understanding of the morphometric parameters of the lumbar pedicles is essential for transpedicular screw fixation. The purpose of this study is to establish a database for proper spinal instrumentations in Chinese patients.

METHODS

A total of 764 pedicles (L2-S1) were measured from spinal computed tomography (CT) of 100 Chinese volunteers. Parameters related to transpedicular fixation include pedicle width (PW), pedicle transverse angle (PTA), pedicle angle measured from the entry point of Roy-Camille through the midpoint of the pedicle (PPA), screw insertion depths to the anterior cortex from the entry point of Roy-Camille along the line parallel to the midsagittal line (PPLP) and from the entry point of Magerl along the pedicle axis (PPLS).

RESULTS

The mean age of the volunteers was 46.2 years. The average PWs from L2 to S1 were: 0.85 +/- 0.15 cm for L2, 0.92 +/- 0.22 cm for L3, 1.19 +/- 0.24 cm for L4, 1.70 +/- 0.28 cm for L5 and 2.31 +/- 0.35 cm for S1. The average PTAs from L2 to S1 were: 13.9 degrees +/- 4.9 degrees for L2, 13.4 degrees +/- 5.1 degrees for L3, 16.2 degrees +/- 5.9 degrees for L4, 27.8 degrees +/- 7.2 degrees for L5 and 44.0 degrees +/- 8.4 degrees for S1. The average PPAs from L2 to S1 were: 5.3 degrees +/- 2.4 degrees for L2, 6.3 degrees +/- 2.2 degrees for L3, 7.2 degrees +/- 2.5 degrees for L4, 10.1 degrees +/- 3.6 degrees for L5 and 17.0 degrees +/- 4.8 degrees for S1. The average PPLPs from L2 to S1 were: 5.64 +/- 0.82 cm for L2, 5.05 +/- 0.62 cm for L3, 4.99 +/- 0.89 cm for L4, 4.42 +/- 0.77 cm for L5 and 4.23 +/- 0.72 cm for S1. The average PPLSs from L2 to S1 were: 5.75 +/- 0.72 cm for L2, 5.24 +/- 0.75 cm for L3, 5.27 +/- 0.84 cm for L4, 4.88 +/- 0.72 cm for L5 and 4.99 +/- 0.72 cm for S1.

CONCLUSIONS

Transpedicular screw fixation should be tailored on individual basis. Though variation exists, no sufficient evidence can be found to suggest major morphometric differences of the Chinese lumbar pedicles from the studies in the English literature.

摘要

背景

全面了解腰椎椎弓根的形态测量参数对于椎弓根螺钉固定至关重要。本研究的目的是建立一个针对中国患者的合适脊柱器械植入的数据库。

方法

从100名中国志愿者的脊柱计算机断层扫描（CT）中测量了总共764个椎弓根（L2-S1）。与椎弓根固定相关的参数包括椎弓根宽度（PW）、椎弓根横角（PTA）、从Roy-Camille入点经椎弓根中点测量的椎弓根角度（PPA）、从Roy-Camille入点沿平行于矢状中线的线到前皮质的螺钉插入深度（PPLP）以及从Magerl入点沿椎弓根轴线到前皮质的螺钉插入深度（PPLS）。

结果

志愿者的平均年龄为46.2岁。L2至S1的平均PW分别为：L2为0.85±0.15厘米，L3为0.92±0.22厘米，L4为1.19±0.24厘米，L5为1.70±0.28厘米，S1为2.31±0.35厘米。L2至S1的平均PTA分别为：L2为13.9度±4.9度，L3为13.4度±5.1度，L4为16.2度±5.9度，L5为27.8度±7.2度，S1为44.0度±8.4度。L2至S1的平均PPA分别为：L2为5.3度±2.4度，L3为6.3度±2.2度，L4为7.2度±2.5度，L5为10.1度±3.6度，S1为17.0度±4.8度。L2至S1的平均PPLP分别为：L2为5.64±0.82厘米，L3为5.05±0.62厘米，L4为4.99±0.89厘米，L5为4.42±0.77厘米，S1为4.23±0.72厘米。L2至S1的平均PPLS分别为：L2为5.75±0.72厘米，L3为5.24±0.75厘米，L4为5.27±0.84厘米，L5为4.88±0.72厘米，S1为4.99±0.72厘米。