术前CT测量胸腰椎椎弓根相关参数在螺钉内固定术中的应用

目的探讨术前CT测量胸腰椎椎弓根相关参数在椎弓根螺钉内固定术中的应用价值。方法 63例胸腰椎椎弓根损伤患者于螺钉内固定术前均行拟固定椎体节段的椎弓根层面薄层CT扫描,图像传输至PACS医生诊断工作站,选择椎弓根最宽层面测量以下参数:椎弓根水平面角(PHA),椎弓根轴心线长度(PAL),钉道长度(LSC),椎弓根内横径(PTD)。结果 T1～12及L1～5椎弓根水平面角逐渐增大;T1～10及L1～4椎弓根轴心线长度逐渐增长,T111、2较T10短,L5较L4短,S1较L5短;T1～6椎弓根内横径逐渐变小,T7～12椎弓根内横径逐渐增大。胸腰段椎弓根水平面角、内横径及轴心线长度在不同个体及不同节段存在差异性。根据椎弓根水平面角,确定进钉的方向,根据椎弓根内横径,选择螺钉的最大直径,根据椎弓根轴心线长度,确定螺钉的总长度和螺钉植入深度。根据CT测量椎弓根相关数据进行个性化置钉,术后CT扫描证实螺钉全部准确置入椎弓根内。结论通过术前CT测量不同节段胸腰椎椎弓根相关数据,制定个性化的置钉方案,可提高置钉准确率及减少并发症。

Application of preoperative CT measurements of thoracolumbar pedicle-related parameters in the internal screw fixation

Objective To evaluate the utility of preoperative CT measurement of thoracolumbar pedicle-related parameters in the internal screw fixation.Methods Sixty-three patients with thoracolumbar pedicle injuries underwent thin slice CT scans before internal screw fixation.Subsequently,the source images were transferred into PACS medical diagnostic workstation and measured following parameters on the widest dimension of pedicles: pedicle horizontal angle(PHA),pedicle axis length(PAL),length of screw channel(LSC),an...