摘要
目的探讨腰椎棘突中轴线与椎弓根进钉通道的三维位置关系,为腰椎内固定和辅助固定技术及临床应用提供个性化、精准化的解剖学数据参考。方法将CT数据通过三维重建和逆向工程软件处理,测量椎体70%和90%边界深度的椎弓根进钉通道所在轴线L和棘突中轴线M与三维参考平面夹角,以及交点与线及三维参考平面距离。结果 (1)腰椎棘突中轴线与矢状面、水平面、冠状面夹角分别为2o^3o、11o^18o、71o^77o;椎体70%和90%边界深度的椎弓根进钉通道与矢状面夹角分别为7o^22o和16o^33o,与水平面夹角分别为1.8o^2.9o和1.4o^2.4o,与冠状面夹角分别为67o^82o和56o^73o;(2)随腰椎水平降低,点到线的距离呈规律性变化;(3)随腰椎水平降低,点到三个平面的距离也呈规律性变化。结论通过对腰椎棘突中轴线与70%和90%边界深度的椎弓根进钉通道的三维关系分析,为临床经皮椎弓根螺钉置入手术和相关器械设计提供数据参考。
Objective To investigate the three- dimensional relationship between the spinous processes of lumbar vertebrae and the pedicle insertion channel, and to provide anatomical basis for lumbar spine fixation and the application of auxiliary fixation techniques. Methods CT scan images were imported into Mimics 18.0 software（Materalise） and UG13.2 imaging software for measurement. Firstly, the line L was located in the pedicle insertion channel, and the line M represented the medial axis of the spinous processes of lumbar vertebrae, then the angles between two lines and the three-dimensional reference plane in 70% and 90% boundary depth were measured, respectively. Secondly, the line L and the anterior surface of centrum intersected at A, the line L and the posterior surface vertebral arch intersected at B,the line L intersected the coronal plane at C were observed. Thirdly, the line M intersected the anterior wall of pedicle plate and the back edge of spinous process at D, E respectively were observed. Finally, the distances between point A, B, C and line L, M and three-dimensional reference plane were measured respectively. Results（1）The angels between the medial axis of the lumbar spinous process and the sagittal, coronal and horizontal planes were 2°～3°, 11° ～18° and 71° ～77° respectively. The angles between the pedicle insertion channel and the sagittal plane in 70%, 90% boundary depth were 7o～22o and 16°～33° respectively. The angles between the pedicle insertion channel and the horizontal plane in 70%,90% boundary depth were 1.8°～2.9° and 1.4o～2.4°.The angles between the pedicle insertion channel and the coronal plane in 70%, 90% boundary depth were67°～82°and 56°～73°;（2）With the decrease of the level of lumbar vertebrae, the distance between points and lines changed regularly;（3） The distance between points and planes changed regularly. Conclusion The three-dimensional relationship between the medial axis of spinous processes and the pedicle insertion channel in 70%, 90% boundary depth in this study have been analyzed, and the anatomical basis been laid for percutaneous cervical pedicle screw placement and its instrument design.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2016年第2期145-150,共6页
Chinese Journal of Clinical Anatomy
基金
湖南省自然科学基金项目(2014JJ2124)
湖南省教育厅重点项目(13A085)
关键词
棘突中轴线
椎弓根进钉通道
三维关系
腰椎
Medial axis line of spinous process
Pedicle insertion channel
Three-dimensional relationship
Lumbar vertebra
