腰椎-髂骨固定的临床解剖学研究

目的:通过对成人尸体髂骨固定的相关数据进行测量,提出髂骨后柱的概念,为腰椎-髂骨固定提供临床解剖学依据。方法:选用保存完好的尸体骨及干燥骨。设定髂前下棘下缘向后经过臀后线与髂嵴后部交叉点的连线截面为A线截面,此线与Chiotic线平行(Chiotic线与髂嵴后部交叉点称为CLIC点)。沿A线和Chiotic线截断髂骨,测量以下数据:髂骨后柱的长度、宽度和高度,观察坐骨大切迹及髂粗隆的解剖学形态;用该技术治疗骶骨骨折5例,骶骨肿瘤6例。结果:髂骨后柱的平均长度为110.57mm,宽度24.24mm;高度有两个,标准高度是坐骨大切迹顶弧到弓状线的垂直高度14.54mm,安全高度是坐骨大切迹顶弧到A线截面的距离31.46mm。CLIC点距坐骨大切迹前支85.43mm。结论:髂骨后柱是髂骨后部的承重骨骼,可容纳7mm直径的髂骨棒植入。

Clinical anatomy of lumboiliac fixation

Objective: To describe anatomic features of posterior column of ilium (PCI) and analyze the feasibility of lumboiliac fixation with Galveston technique through the related anatomic measurement of ilium. Methods:A total of 10 hemi-sectional pelvises and 7 dry iliac bones were harvested. One line from inferior edge of anteroinferior iliac spine to the crossing point of posterior gluteal line and posterior iliac crest was defined as A line, which was parallel to the Chiotic line (the crossing point of Chiotic line and posterior iliac crest called CLIC point).We cut the bone from A line to Chiotic line for observing the morphologic characteristics of posterior iliac column(PCI),iliac tuberosity, greater sciatic notch, as well the length and height of PCI.Results:The average length of PCI was about 110.57 mm, the width 24.24 mm, the height between the greater sciatic notch(GSN) and arcuate line 14.54 mm and that of A line section to GSN 31.46mm. The distance between the CLIC to the greater sciatic notch was about 85.43 mm. Conclusions:PCI is a weight-bearing bone of the back part of ilium for its special thickness,therefore, the iliac rod of 6-7mm diameter can be inserted into it during the operation.