MSCT三维重建技术在胸腰椎骨折患者经椎弓根螺钉内固定术中的应用研究

目的：探讨MSCT三维重建技术在胸腰椎骨折患者经椎弓根螺钉内固定术中的应用效果，为手术方案的施行提供置钉指导。方法选择我院2010年2月至2013年2月收治的胸腰椎骨折患者60例，选择32层螺旋CT机（MSCT）建立椎弓根螺钉分析模型，并进行相关数据的测量与对比。结果所有测量指标的椎弓根左右两侧数值对比无明显差异（P＞0.05）。不同节段的测量指标对比有明显差异（P＜0.05），其中内外夹角、内外弧长、上下夹角、上下弧长、实验钉长、钉道长为逐渐减少的趋势，而螺钉直径、钉尾间距、水平面进钉角（TSA）与矢状面进钉角（SSA）值为逐渐增加的趋势。结论 MSCT三维重建技术应用于胸腰椎骨折患者可指导临床进行个性化经椎弓根螺钉内固定术，为患者的诊断和手术设计提供了一种新的影像解剖学依据。

The applying analysis of MSCT three-dimensional reconstruction technology for pedicle screw and internal fixation in thoracic and lumbar fractures patients

Objective To investigate the applying effects of MSCT three-dimensional reconstruction technology for pedicle screw and internal fixation in thoracic and lumbar fractures patients. Methods Select 60 cases with thoracic and lumbar fractures from February 2010 to February 2013 in our hospital, used the 32-layer spiral CT machine （MSCT） to establish the pedicle screw analysis model, and given the relevant data contrasted and measured. Results The all measurement indicators between the left and right pedicle contrasted had no significant difference （P〉0.05）. but had significant differences （P〈0.05） in the different segments, the inside and outside the angle, inside and outside the arc length, the upper and lower angle, the upper and lower arc length and the experimental and nail length, the screw diameter, screw tail pitch were showed the trend of gradually reduce, and the TSA and the SSA values were showed the trend of gradually increase. Conclusion MSCT three-dimensional reconstruction technology applied to thoracic and lumbar fracture patients can be guide the clinical to carried out the personalized fixation by the pedicle screw, and it provides a new anatomy basis for the diagnosis and surgery.