Breed specific osteological features of the canine lumbosacral junction.

Inefficient facet geometry suggests the lumbosacral junction to be mechanically imperfect in a large number of dogs (especially German Shepherd Dogs) resulting in a significantly higher prevalence of osteophyte formation and increase in the longitudinal extension of the articular surface covering the caudal articular process of the seventh lumbar vertebra. Such osteological features give evidence for lumbosacral craniocaudal translation, were predominantly noticed in combination with axial rotation and are taken to be anatomic risk factors that can predispose to the development of lumbosacral stenosis. The statistically significant relationship between age and the magnitude of the caudal facet inclination angles of the seventh lumbar vertebra in juvenile specimens indicate an affection of the three-dimensional modeling of the immature caudal articular processes by formative stimuli such as body weight and locomotion. However, results additionally indicate an association between the magnitude of these inclination angles and vertebral body dimensions also suggesting a congenital influence on facet geometry.     

Which portion in a facet is specifically affected by articular cartilage degeneration with aging in the human lumbar zygapophysial joint?

Using 10 osteoligamentous vertebral columns obtained from elderly donated cadavers, we describe in detail degenerative changes of the articular cartilage in lumbar zygapophysial joints to show which portion in a facet is specifically affected. Degenerative changes, including extended cartilage defects, occurred in multiple facets of every specimen. The results demonstrated 5 basic morphologies of degeneration, i.e., 1) marginal dominace in the articular surface, 2) lower segment dominance except for the lowest (L5/S) facet, 3) advancement in the inferior articular process, 4) cranial and caudal dominance rather than the dorsal dominance in the articular surface and 5) progress in a mirror-image manner. These rules seemed to be consistent with differences in size, shape and kinesiological aspects of the facet between segments and between portions in a facet.     

Lower axial skeleton of the musk shrew (Suncus murinus)

Macroscopic structure as well as pre- and postnatal development of the lumbar, sacral, and caudal vertebrae of the musk shrew (Suncus murinus, Insectivora) were observed. The lumbar vertebrae possess two pairs of unusual processes, hyperapophyses and hypapophyses. The hyperapophyses are located on the dorsal surface of the caudal articular processes of all the lumbar vertebrae, whereas the hypapophyses are found on the caudal part of the ventral surface of the bodies in the first few lumbar vertebrae. The former gives attachment to the Mm. rotatores lumborum and the latter to the Mm. psoas major and minor. The articular processes of the lumbar vertebrae are oriented more horizontally compared with those in other mammals. The sacrum is very narrow transversely due to poor development of the ventrolateral wing. The auricular surface includes cranial parts of the wing and of the fused vertebral arches as well as the cranial articular process of the first sacral vertebra. In the caudal vertebrae, chevron bones are H-shaped when viewed ventrally, and give attachment to tendons of the caudal muscles. This report describes the relationships between the structural peculiarities of the lower axial skeleton and the locomotive habits of the musk shrew.     

Radiographic and Magnetic Resonance Imaging Identification of Thoracolumbar Spine Variants with Implications for the Positioning of the Conus Medullaris in Rhesus Macaques

The anatomy of the vertebral column in mammals may differ between species and between subjects of the same species, especially with regards to the composition of the thoracolumbar spine. We investigated, using several noninvasive imaging techniques, the thoracolumbar spine of a total of 44 adult rhesus macaques of both genders. Radiographic examination of the vertebral column showed a predominant spine phenotype with 12 rib‐bearing thoracic vertebrae and 7 lumbar vertebrae without ribs in 82% of subjects, whereas a subset of subjects demonstrated 13 rib‐bearing thoracic vertebrae and 6 lumbar vertebrae without ribs. Computer tomography studies of the thoraco‐lumbar spine in two cases with a pair of supernumerary ribs showed facet joints between the most caudal pair of ribs and the associated vertebra, supporting a thoracic phenotype. Magnetic resonance imaging (MRI) studies were used to determine the relationship between the lumbosacral spinal cord and the vertebral column. The length of the conus medullaris portion of the spinal cord was 1.5 ± 0.3 vertebral units, and its rostral and caudal positions in the spinal canal were at 2.0 ± 0.3 and 3.6 ± 0.4 vertebral units below the thoracolumbar junction, respectively (n = 44). The presence of a set of supernumerary ribs did not affect the length or craniocaudal position of the conus medullaris, and subjects with13 rib‐bearing vertebrae may from a functional or spine surgical perspective be considered as exhibiting12 thoracic vertebrae and an L1 vertebra with ribs. Anat Rec, 300:300–308, 2017. © 2016 Wiley Periodicals, Inc.     

Changes in the surface of the superior articular joint from the lower thoracic to the upper lumbar vertebrae

Thirty-two human vertebral columns were selected from the Kanazawa Collection at the University of Kanazawa, Japan. The superior articular joint surface was categorised into the thoracic type and the lumbar type, and the pattern of the change from one type to the other in the lower thoracic and upper lumbar region was examined. In 21 of 32 cases (66%), the change from the thoracic to the lumbar type occurred over 2 vertebral segments, either between the 12th thoracic and 1st lumbar vertebrae (44%) or between the 11th and 12th thoracic vertebrae (22%). In the remaining 11 cases (34%), the change occurred over 3 vertebral segments, with a transitional type of articular surface. The change from the thoracic to lumbar type of articular surface has been believed to occur over 2 vertebral segments, but occurs over 3 segments in as many as 34% of the articular surfaces.     

The orientation of the articular facets of the zygapophyseal joints at the cervical and upper thoracic region

Knowledge of the orientation of facet joints in the cervical and upper thoracic region is important for understanding the biomechanical properties and clinical conditions relevant to the neck. The study was undertaken on dry macerated bones from 30 adult male human vertebral columns. The orientation of the superior articular facets in relation to their inclination with the sagittal and transverse planes was examined between C3 and T3 vertebrae in each column. The linear dimensions of the superior articular facets and the width/height ratio were also calculated. The results show that all vertebrae at C3 level and 73% at C4 level displayed posteromedially facing superior articular facets. Similarly at T1 level (C7/T1 joint) and below, all columns showed posterolaterally facing superior articular facets. The level of change in orientation, from posteromedial to posterolateral facing superior facets, was not constant and occurred anywhere between C4 (C3/C4 joint) and T1 (C7/T1 joint). The change in orientation followed 2 different patterns, i.e. sudden or gradual. The C6 vertebra (C5/C6 joint) was the most frequent site to show the transition. The shape of the superior articular facets was circular to oval at C3, C4 and C5 levels and gradually changed to a transversely elongated surface at C7 and T1. These findings correlate well with various cervical movements and associated clinical conditions.     

Mechanism of change in the orientation of the articular process of the zygapophyseal joint at the thoracolumbar junction

The orientation of the superior articular processes in thoracic and lumbar vertebrae differs. The present study was undertaken to investigate the possible mechanism for the change from a posterolaterally facing superior articular surface in the thoracic region to a posteromedially facing curved articular surface in the lumbar region. The material of the study consisted of dry macerated bones of 44 adult human vertebral columns. The orientation of the superior articular process and its relation to the mamillary tubercle (process) was examined between T9 and L5 vertebrae in each column. An abrupt change from the thoracic to lumbar type of articular process was observed in 3 columns (7%). Forty-one (93%) columns showed a gradual change extending over either 2 or 3 successive vertebrae. The present study suggests that the change in the orientation of the superior articular process, from the coronal to the sagittal plane (sagittalisation), occurs due to the change in the direction of weight transmission through zygapophyseal joints at the thoracolumbar junction. It was observed that the gradual sagittalisation of the superior articular process in the transitional zone brought it close to the mamillary tubercle which eventually fused with it. Thus the study suggests that the characteristic posteromedially facing concave superior articular process of lumbar vertebrae may have formed because of the fusion of the articular process and the mamillary tubercle.     

Regional differences in zygapophysial joint cavities: A histological study of human fetuses

Human zygapophysial joints (ZJ) have regional differences in shape and orientation during prenatal growth. However, there is limited knowledge of the synovial recess during fetal development. We examined sagittal and horizontal histological sections of the vertebral columns of 30 human fetuses at gestational ages of 8–37 weeks. Fetuses of all gestational ages had subaxial cervical articular processes that were thicker than in the thoracolumbar regions, and as large as the corresponding vertebral bodies. A small or large synovial recess extending beyond the articular cartilage was evident at most regions. The cervical ZJ had large or deep recesses that extended inferiorly in midterm fetuses and posteromedially along the vertebral pedicle and lamina in near-term fetuses. Likewise, the thoracic ZJ had small recesses that extended superiorly in midterm fetuses and medially in near-term fetuses. The lumbar recesses extended laterally beyond the medially shifted articular cartilage of the upper adjacent vertebrae in near-term fetuses and the lumbar articular surface was smallest in the three regions at all stages. At any region, a deep recess appeared before an area expansion of the ZJ cartilage. A drastic change in direction and size of the prenatal recess seemed to occur depending on a possible minute dislocation of the ZJ. In particular, a deep posteromedial recess of the cervical ZJ, which extended far beyond the articular cartilage, might be necessary to maintain high flexibility suitable for the strong flexion posture in utero.     

Trajectory architecture of the trabecular bone between the body and the neural arch in human vertebrae

The cancellous structure of vertebrae has been studied to investigate the direction of trabeculae and thus the lines of stress. The trabecular bone of the pedicle, connecting the body to the lamina, differed in different regions of the vertebral column. At C2 level, it was found that trabeculae are involved in transfer of th column. At C2 level, it was found that trabeculae are involved in transfer of the compressive forces from the superior articular surface to the inferior articular process and body. Throughout the thoracic region, trabeculae in the pedicle were inclined anteriorly towards the body, indicating that compressive forces in the thoracic spine are transferred from the neural arch to the body. In the lower lumbar region, trabeculae run from the body towards the neural arch. Trabeculae in the thoracic transverse processes extend from the costal facet to the lamina, suggesting that weight brought by the ribs to the costotransverse articulations is transmitted to laminae through transverse processes.     

Prediction of the human thoracic and lumbar articular facet joint morphometry from radiographic images

The articular facet joints (AFJ) play an important role in the biomechanics of the spine. Although it is well known that some AFJ dimensions (e.g. facet height/width or facet angles) play a major role in spinal deformities such as scoliosis, little is known about statistical correlations between these dimensions and the size of the vertebral bodies. Such relations could allow patient-specific prediction of AFJ morphometry from a few dimensions measurable by X-ray. This would be of clinical interest and could also provide parameters for mathematical modeling of the spine. Our purpose in this study was to generate prediction equations for 20 parameters of the human thoracic and lumbar AFJ from T1 to L4 as a function of only one given parameter, the vertebral body height posterior (VBHP). Linear and nonlinear regression analyses were performed with published anatomical data, including linear and angular dimensions of the AFJ and vertebral body heights, to find the best functions to describe the correlations between these parameters. Third-order polynomial regressions, in contrast to the linear, exponential and logarithmic regressions, provided moderate to high correlations between the AFJ parameters and vertebral body heights; e.g. facet height superior and interfacet width (R2, 0.605-0.880); facet height inferior, interfacet height and sagittal/transverse angle superior (R2, 0.875-0.973). Different correlations were found for facet width and transverse angle inferior in the thoracic (R2, 0.703-0.930) and lumbar (R2, 0.457-0.892) regions. A set of 20 prediction equations for AFJ parameters was generated (P-values < 0.005, anova). Comparison of the AFJ predictions with experimental data indicated mean percent errors <13%, with the exception of the thoracolumbar junction (T12-L1). It was possible to establish useful predictions for human thoracic and lumbar AFJ dimensions based on the size of the vertebral bodies. The generated set of equations allows the prediction of 20 AFJ parameters per vertebral level from the measurement of the parameter VBHP, which is easily performed on lateral X-rays. As the vertebral body height is unique for each person and vertebral level, the predicted AFJ parameters are also specific to an individual. This approach could be used for parameterized patient-specific modeling of the spine to explore the clinically important mechanical roles of the articular facets in pathological conditions, such as scoliosis.     

Association of rudimentary sacral zygapophyseal facets and accessory and ligamentous articulations: Implications for load transmission at the L5‐S1 junction

Weight transmitted from the fifth lumbar vertebrae to the sacrum is distributed as three separate components between (a) the vertebral bodies anteriorly, (b) the transverse elements intermediately, and (c) the lumbosacral facet joints, posteriorly. The posterior components of the fifth lumbar vertebra share greater proportion of load in comparison with the posterior elements of the upper lumbar vertebral levels. This study focuses on rudimentary lumbosacral facet articulations and their possible effects on load sharing at this region. Twenty sacra bearing rudimentary articulations were collected for analysis. Sixteen of these sacra presented unilateral rudimentary facets, and the remaining four had facets that were bilaterally rudimentary. Thirteen of the sacra with unilateral rudimentary facets showed an accessory articulating area on the upper surface of the ala on the same side as the rudimentary zygapophyseal facet. The remaining three sacra (out of the 16) showed evidence of strong ligamentous attachments between the L5 and S1 transverse elements on the sides of the rudimentary facets. All the sacra with bilateral rudimentary facets demonstrated bilateral accessory L5–S1 articulations. These observations indicated that load transmission at lumbosacral junctions bearing a rudimentary facet joint is not normal and that their associations with strong L5–S1 lumbosacral ligamentous attachments or accessory articulations at the transverse elements serve a compensatory mechanism for load sharing. Clin. Anat. 23:707–711, 2010. © 2010 Wiley‐Liss, Inc.     

C7 vertebra homeotic transformation in domestic dogs – are Pug dogs breaking mammalian evolutionary constraints?

The number of cervical vertebrae in mammals is almost constant at seven, regardless of their neck length, implying that there is selection against variation in this number. Homebox (Hox) genes are involved in this evolutionary mammalian conservation, and homeotic transformation of cervical into thoracic vertebrae (cervical ribs) is a common phenotypic abnormality when Hox gene expression is altered. This relatively benign phenotypic change can be associated with fatal traits in humans. Mutations in genes upstream of Hox, inbreeding and stressors during organogenesis can also cause cervical ribs. The aim of this study was to describe the prevalence of cervical ribs in a large group of domestic dogs of different breeds, and explore a possible relation with other congenital vertebral malformations (CVMs) in the breed with the highest prevalence of cervical ribs. By phenotyping we hoped to give clues as to the underlying genetic causes. Twenty computed tomography studies from at least two breeds belonging to each of the nine groups recognized by the Federation Cynologique Internationale, including all the brachycephalic ‘screw‐tailed’ breeds that are known to be overrepresented for CVMs, were reviewed. The Pug dog was more affected by cervical ribs than any other breed (46%; P < 0.001), and was selected for further analysis. No association was found between the presence of cervical ribs and vertebral body formation defect, bifid spinous process, caudal articular process hypoplasia/aplasia and an abnormal sacrum, which may infer they have a different aetiopathogenesis. However, Pug dogs with cervical ribs were more likely to have a transitional thoraco‐lumbar vertebra (P = 0.041) and a pre‐sacral vertebral count of 26 (P < 0.001). Higher C7/T1 dorsal spinous processes ratios were associated with the presence of cervical ribs (P < 0.001), supporting this is a true homeotic transformation. Relaxation of the stabilizing selection has likely occurred, and the Pug dog appears to be a good naturally occurring model to further investigate the aetiology of cervical ribs, other congenital vertebral anomalies and numerical alterations.     

Morphometric analysis of the thoracic and lumbar spine in Japanese on the use of pedicle screws

The pedicle screw and hook have become popular instruments in treating spinal deformity and disease. This study gathered morphological data on thoracic and lumbar spines in a Japanese population that should serve as useful reference for posterior instrumentation surgery. One hundred and three dry bones were used to investigate the morphology of pedicle and facet in thoracic and lumbar spines. Measurements included the diameter and axial length of pedicle from T8 to L5, height and width of facets and thickness of articular processes from T1 to T12, and axial angle of pedicle from T1 to L5. The diameter and axial length of pedicle were smallest at T8, diameter was largest at L5 and axial length was largest at L3. Height of facets and thickness of articular processes were largest at T12. Men tended to have larger pedicles and facets than women. Transverse angle of pedicle was smallest at T12. These precise data may provide useful information when performing posterior instrumentation surgery and when developing new spinal implant systems for Asians.     

The diameter of the vertebral canal in dogs in cases of lumbosacral transitional vertebrae or numerical vertebral variations

From Th1 to L7 midsagittal and interpedicular vertebral canal diameters were measured in macerated spines of 162 dogs to determine, whether the presence of lumbosacral transitional vertebrae or numerical vertebral variations are associated with dislocation of the maximal enlargement of the lumbar vertebral canal. Relative to dogs with a regular number of 27 presacral vertebrae (C7/Th13/L7), the maximal enlargement of the lumbar vertebral canal was more frequently ( P < 0.05) located at vertebra 24 in dogs with 26 presacral vertebrae (C7/Th13/L6), and more frequently at vertebra 25 in dogs with 28 presacral vertebrae (C7/Th13/L8). However, in dogs with 26 presacral vertebrae, maximal agreement in the spinal position of maximal lumbar vertebral canal diameters was achieved relative to dogs with 28 presacral vertebrae by adding one additional thoracic (Th6, 7, or 8) segment. Therefore, the present findings strongly suggest that relative to the regular (C7/Th13/L7) condition, decrease in the number of presacral vertebrae (C7/Th13/L6) is associated with incorporation of a midthoracic segment, whereas increase in the number of presacral vertebrae (C7/Th13/L8) is not related to the presence of an additional vertebral segment. When using Th1 as landmark, the difference in the position of the maximal enlargement of the lumbar vertebral canal between dogs with 26 and dogs with 28 presacral vertebrae in average was only one segment. It is known from previous reports that the maximal enlargement of the lumbar vertebral canal corresponds with the maximal enlargement of the lumbar spinal cord. When using S1 or the transitional vertebra as the landmark for determination of the appropriate site for subarachnoid cannulation, this site is expected to range within the same limits regardless of the vertebral formula.     

Innervation of the canine thoracolumbar vertebral column

The pattern of innervation of the caudal thoracic and cranial lumbar vertebral column of the dog is described. Frozen sections stained with Schofield's silver impregnation method show that the dorsal longitudinal ligament is profusely innervated, while the anulus fibrosus contains a few nerves limited to its outermost layers; no nerves are present in the nucleus pulposus. Following injection of horseradish peroxidase (HRP) into the anulus fibrosus of the thoracolumbar intervertebral disc and subsequent removal and staining of dorsal root ganglia, the reaction product is found in ganglia as far as two segments cranially as well as caudally, demonstrating that the disc is innervated by nerves arising from several spinal cord segments. A meningeal ramus, which innervates the discs of man, could not be found by gross dissection. Dissections show each vertebral articular facet innervated by the medial branches of two contiguous spinal nerves, a pattern further confirmed by injections of HRP into facet joints with subsequent staining of dorsal root ganglia. The dorsal rami of spinal nerves often divide into medial, intermediate, and lateral branches rather than the traditionally described division into only medial and lateral branches.     

Osteological features in pure-bred dogs predisposing to cervical spinal cord compression

Relative to body size, midsagittal and interpedicular diameters of the cranial and caudal aspects of cervical vertebral foramina (C3–C7) were found to be significantly ( P < 0·05) larger in small breeds than in large breeds and Dachshunds, and also larger in Dachshunds ( P < 0·05) than in large breeds. This condition increases the risk for spinal cord compression resulting from relative stenosis of the cervical vertebral foramina, especially in large dogs, and this is also exacerbated by the typical shape of the vertebral foramina (i.e. dorsoventrally flattened cranially and bilaterally narrowed caudally). Within large dogs those breeds highly predisposed to cervical spinal cord compression were Great Danes (the breed with the smallest midsagittal vertebral foramen diameters from cranial C6 to cranial T1) and Doberman Pinschers, because of the most strikingly cranially dorsoventrally narrowed cone-shaped vertebral foramina at C6 and C7. The existence of a small midsagittal diameter in the cranial cervical spine was a high risk factor predisposing to spinal cord compression in small breeds and Dachshunds. Remarkable consistency was noted between the spinal level of the maximum enlargement of the spinal cord which previously was reported to be at C6, and the site of maximum enlargement of the vertebral canal currently stated in Dachshunds and small breeds. In large breeds the maximum enlargement of the vertebral canal tended to be located more caudally at the caudal limit of C7. The average age at which large dogs were most susceptible to noxious factors causing abnormal growth of the pedicles was determined to be 16 wk.     

Modeling intervertebral articulation: The rotule à doigt mechanical joint (RAD) in birds and mammals

The vertebrate skeleton is composed of articulated bones. Most of the articulations are classically described using mechanical joints, except the intervertebral joint. The aim of this study was to identify a joint model with the same mechanical features as the cervical joints. On the neck vertebrae, six articular surfaces participate in the joint: the cranial part of the centrum and the facets of the two prezygapophyses of a vertebra articulate on the caudal part of the centrum and the two articular facets of the postzygapophyses of the previous vertebra. We used the intervertebral joints of the birds neck to identify the mechanical joint representing intervertebral linkage. This link was described in the literature as a joint allowing two or three rotations and no translation. These features correspond to the rotule à doigt (RAD) joint, a ball and socket joint with a pin. We compared the RAD joint to the postaxial intervertebral joints of the avian neck and found it a suitable model to determine the geometrical features involved in the joint mobility. The difference in the angles of virtual axes linking the geometrical center of the centrum to the zygapophysis surfaces determines the mean dorsoventral flexion of the joint. It also helps to limit longitudinal rotation. The orientation of the zygapophysis surfaces determines the range of motion in both dorsoventral and lateral flexion. The overall system prevents dislocation. The model was validated on 13 joints of a vulture neck and 11 joints of a swallow neck and on one joint (C6–C7) in each of three mammal species: the wolf (Canis lupus), mole (Talpa europaea), and human (Homo sapiens). The RAD mechanical joint was found in all vertebral articulations. This validation of the model on different species shows that the RAD intervertebral joint model makes it possible to extract the parameters that guide and limit the mobility of the cervical spine from the complex shape of the vertebrae and to compare them in interspecific studies.     

Segmental variations in the elastic fiber content of the lateral costotransverse ligaments in the vervet monkey (Cercopithecus pygerythrus aethiops)

The segmental and zonal variations in the quantitative relationships between elastic and collagen fibers within the lateral costotransverse ligaments have been investigated in the vervet monkey. The lateral costotransverse ligaments of the caudal segments have a largely elastic structure in contrast to those of the cranial segments, which are characteristically collagenous. In the transitional zone extending from the 4th through to the 6th costotransverse joints, the lateral costotransverse ligaments show a zonal differentiation into a superficial collagenous portion and a deep elastic portion. It is noted that the craniocaudal structural differentiation in the lateral costotransverse ligaments corresponds with similar changes in the vertebral ligaments in that the ligamenta flava gradually extend into the interspinous spaces from the 1st thoracic vertebra (T1) so that at T5 the ligaments occupy 50% of the interspinous space and at T7 the elastic fibers almost completely replace the interspinous ligament. Functionally, however, the regional differences in the elastic fiber content of the lateral costotransverse ligament may have no collateral relationship with the morphology of the ligamenta flava, but are conditioned by movements of the ribs. Whereas movements of the upper six joints are limited by virtue of the configuration of their articular surfaces, which are reciprocally curved, on the 7th to 10th joints the articular facets are almost flat and, therefore, allow considerable movements between the ribs and the corresponding transverse processes.     

CT多平面重建预评估腰椎经皮椎弓根螺钉置入损伤关节突关节的风险

文题释义：CT多平面重组技术：是将扫描范围内所有的轴位图像叠加起来在对某些标线标定的重组线所指定的组织进行冠状位、矢状位及任意角度斜位图像重组,以在不同角度观察影像学图像。 经皮椎弓根螺钉：该技术采用在术中影像检查设备引导下经皮肤小切口置入椎弓根螺钉,与常规开放置钉手术相比明显减少了对椎旁肌的损伤程度,既往学者多关注螺钉与椎弓根壁的位置关系,而较少关注其与关节突关节的位置关系。 背景：经皮椎弓根螺钉内固定技术被广泛应用于治疗腰椎疾病。经皮椎弓根螺钉由于是在术中C形臂X射线引导下操作,对螺钉与关节突关节之间的位置关系难以完全控制,可能导致关节突关节损伤。既往有学者认为体质量指数>29.9 kg/m²、小关节角>35°及年龄<65岁是经皮椎弓根螺钉损伤关节突关节的高危因素。由于不同腰椎椎弓根轴线与关节突关节的位置关系不同,螺钉对关节突关节的破坏是否存在差异目前尚无相关报道。 目的：探讨腰椎CT多平面重建技术在腰椎经皮椎弓根钉置入术前预估螺钉损伤腰椎关节突关节中的价值。 方法：选择100例行经皮椎弓根钉置入内固定治疗腰椎骨折及腰椎退行性疾病的患者,对治疗方案均知情同意,且得到医院伦理委员会批准。于术前CT斜轴位、斜矢状位及斜冠状位调整多平面重建的定位线,重建出椎弓根的切面断层,以斜冠状位线为中心设置直径为6.5 mm的标定圆模拟经皮椎弓根钉轴向截面,观察标定圆侵犯关节突关节程度,设为术前组;术后行腰椎CT检查观察螺钉损伤关节突关节程度,设为术后组。评价2组间不同节段关节突关节损伤螺钉数及组内不同节段关节突关节破坏比率的差异。 结果与结论：①共计置钉478枚,术前组显示标定圆侵犯关节突关节109枚,占比22.8%,其中L₁-L₅标定圆侵犯关节突关节螺钉数及占比分别为6枚(6.8%)、9枚(10.5%)、19枚(18.3%)、30枚(30.0%)和45枚(45.0%);②术后组显示关节突关节损伤115枚,占比24.1%,其中L₁-L₅螺钉损伤关节突关节螺钉数及占比分别为10枚(11.4%)、7枚(8.1%)、15枚(14.4%)、26枚(26.0%)和41枚(41.0%);③McNemar 配对χ²检验不同腰椎节段P值分别为：L₁ P=0.08,L₂ P=0.22,L₃ P=0.20,L₄ P=0.05,L₅ P=0.08,2组结果比较差异均无显著性意义;④Kappa检验2组一致性分别为：L₁ Kappa值=0.67,L₂ Kappa值=0.80,L₃ Kappa值=0.80,L₄ Kappa值=0.87,L₅ Kappa值=0.92;术前组及术后组组内不同节段间关节突关节损伤比率比较差异有显著性意义(P=0.000);⑤提示腰椎CT多平面重建技术可较为准确地判断经皮椎弓根螺钉与关节突关节的位置关系,为判断术后螺钉是否可能侵犯关节突关节提供了一种可靠的预估方法。 ORCID: 0000-0003-4872-2726(张晓芸) 中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程