自前向后植入骶髂关节螺钉解剖参数的CT测量

目的： 利用CT扫描图像测量自前向后植入骶髂关节螺钉（SISIFATP）的应用解剖参数，为螺钉植入可行 性提供依据。方法：分析健康成人骨盆CT扫描图像。模拟SISIFATP 自髋臼后上缘附近，向后、内、上穿过骶髂 关节和骶椎侧块第1 骶椎上关节突基底。利用CT数字重建技术测量：在横断面内进钉点与髋臼边缘的距离（M）、 通道长度（L）、最小横径（W）、螺钉通道中心轴与矢状面成角（E）和最大偏离角（P）；在矢状面内通道的最 小纵径（H），通道中心轴与第1 骶椎上终板平行线的成角（F）和最大偏离角（Q）。结果：M为5.13 mm±1.81 mm，L 为102.35 mm±7.45 mm，E 为43.79°±2.83°，F 为43.85°±5.57°。W 为16.27 mm±1.99 mm，H为18.31 mm±2.22 mm。P 为11.74°±1.76°，Q 为11.04°±1.59°。结论：SISIFATP 的进点位于髋臼后上边缘附近，出针 点位于第1 骶椎上关节突基底，进钉方向是向后、向上与第1 骶椎上终板平均成角44°、向内与躯干纵轴平均成角 44° ；国人骨盆可选择至少1 枚直径6.0 ～ 7.0 mm、长度90 ～ 100 mm 螺钉植入。

CT measurement of anatomical parameters of sacroiliac screws implanted from anterior to posterior

Objective To measure the anatomical parameters of sacroiliac screw implanted from anterior to posterior （SISIFATP） so as to provide the basis for the feasibility of screw implantation. Methods The CT images of healthy adults pelvis were analyzed. SISIFATP was simulated to pass through sacroiliac joint and sacral lateral mass from posterior superior edge of acetabulum to S1 superior articular process base. The distance between the screw entry point and the edge of the acetabulum（ M）， the length（ L）， the minimum width（W）， the inward angle between the central axis of the screw pathway and the sagittal plane of the human body（ E） and the maximum deviation angle（ P） between the central axis of the pathway and the sagittal plane of the trunk in the transversal plane， and the minimum heighth（ H）， the the upward angle between the center axial of the screw pathway and the parallel line of S1 upper end plate（F） and the maximum deviation angle （Q） in the sagittal plane， were measured by CT digital reconstruction technology. Results M was 5.13 mm±1.81 mm. L was 102.35 mm±7.45 mm. E was 43.35°±5.04° and F was 49.15°±3.34°. W was 16.27 mm±2.09 mm and H was 18.31 mm±2.19 mm. P was 8.38°±1.70° and Q was 9.58°±2.64°， M was 5.13 mm±1.81 mm，L was 102.35 mm±7.45 mm，E was 43.79°±2.83°，F was 43.85°±5.57°， W was 16.27 mm±1.99 mm，H was 18.31 mm±2.22 mm. P was 11.74°±1.76° and Q was 11.04°±1.59°. Conclusion The entry point of SISIFATP nears the supperior-posterior edge of the acetabulum， and the exit point is located at the base of superior articular process of S1. The direction of needling is to pass backward， upward at an average angle of 44 ° to the upper endplate of the S1， and inward at an average angle of 44 ° to the longitudinal axis of human body. At lest one screw with a diameter of 6.0-7.0 mm and a length of 90-100 mm could be implanted as SISIFATP in Chinese.