汉族与维吾尔族青年男性L4，5椎弓根CT形态差异对植入物内固定的影响

背景：国内尚无对于不同种族（汉族和维吾尔族）间椎弓根在横断面上的内偏角、在矢状面上的头/尾偏角以及腰椎椎弓根CT形态学差异的研究报道。目的：评估汉族和维吾尔族成年男性L4,5椎弓根CT形态的差异及其对腰椎后路内固定效果影响。方法：选择400例因腰椎间盘突出症需要行L4,5后路椎弓根螺钉置入内固定的患者,汉族及维吾尔族各200例,均为男性,年龄20～30岁,身高170～175cm。采用CT常规螺旋扫描＋三维图像处理,使用患者浏览器的长度及角度测量工具测量椎弓根横径、椎弓根后缘皮质到椎体前缘皮质的距离及椎弓根在横断面上的内偏角及在矢状面上的头/尾偏角。结果与结论：汉族青年男性L4椎体选择的椎弓根螺钉直径要比维吾尔族青年男性小,否则可能会增加椎弓根崩裂的风险;内偏角应比维吾尔族青年男性大,否则可能会增加螺钉穿出椎体的风险。汉族青年男性L5椎体选用的左侧螺钉直径及左侧内偏角要比维吾尔族青年男性小,否则可能会增加椎弓根崩裂以及螺钉进入椎管损伤神经的风险。

Effect of L4, 5 pedicle CT morphological differences on the internal fixation of implant in Han and Uygur young men

BACKGROUND：In China,there are no studies about the inner deflection angle on cross section,head/tail declination on sagittal plane and morphological differences of the lumbar pedicle CT.OBJECTIVE：To evaluate the CT morphological defferences of L4,5 pedicle between Han and uygur and whether the differences have an influence on internal fixation of posterior lumbar.METHODS：Totally 400 cases who treated with L4,5 posterior pedical screw internal fixation due to lumbar disc herniation were seclected.Han and uygur were 200 male cases respectively aged 20 to 30 years old,height 170-175 cm.Pedicle transverse diameter,length of screw path,transverse section angle and sagitalseetion angle were measured by using length and angle measurement tool of patient browser after imags was eshtablished by conventional spiral CT scan＋three-dimensional image processing.RESULTS AND CONCLUSION：Pedicle diameter of L4 vertebral body in Han should be smaller than that in the uygur,otherwise it might increase the risk of pedicle crack.Inner deflection angle of the Han should be larger than that in the uygur,otherwise it might increase the risk of vertebral body piercing the screws.Pedicle diameter of L5 vertebral body and left inner deflection angle in Han should be smaller than those in the uygur,otherwise it might increase the risk of pedicle crack and screw into the spinal canal to damage nerve.