椎基静脉孔及椎体静脉解剖在椎体成形术中的意义

目的　为胸腰椎（T8～L5）椎体成形术减少骨水泥渗漏等并发症提供解剖学依据。 方法　对40例健康成人胸腰椎螺旋CT薄层扫描和重建，观察每节段正中矢状位和横断位图像上椎基静脉孔（basivertebral foramen, BF）和椎体静脉孔道(vertebral vein, VV)出现的频率；测量椎体正中矢状径（VD）和BF宽（BFW）、深（BFD）高（BFH）；测量BF距椎体左右缘距离（VW1和VW2）和距上下终板的距离（VH1和VH2），应用Stata7.0统计学软件包对上述数据进行统计学分析。 结果 BF及VV出现的频率从T8到L5逐渐增大，BF和VV观察到的频率在性别间差异无统计学意义（P＞0.05）。BFW、BFH、BFD从T8至L5随椎体增大相应增大。在不同椎体上BFD约为VD的1/3。VW1和VW2之间差异无统计学意义（P＞0.05）；VH1和VH2之间差异有统计学差异(P＜0.05)。BF更接近椎体上终板。 结论 熟悉BF和VV在椎体内的分布有助于减少椎体成形术中骨水泥渗漏等并发症的发生。

Anatomic distribution of basivertebral foramen and vertebral vein in vertebral bodies of T8~L5 and its clinical significance in PVP and PKP

Objective　To provide anatomic data for less complications of bone cement leakage in PKP and PVP.　Methods　A total of 40 health adults underwent multi-slice CT thin slice scans and three-dimensional reconstruction. In the horizontal and sagittal CT reconstruction images, display frequency of basivertebral foramen （BF) and vertebral vein (VV）of the branches of basivertebral venous system in vertebral bodies of T8~L5 were calculated. The sagittal diameter of vertebral body (VD), BF weight (BFW), BF depth (BFD), BF high (BFH) were measured. The distance between the BF and each side inthe horizontal and sagittal CT images were also measured. The measured parameters were analyzed statistically.　Result　Display frequency of BF and VV was gradually increasing from T8 to L5. Display frequencies of BF and VV in vertebral bodies were no significantly different between male and female (P>0.05). The distance from the BF to left or right side in the horizontal CT images were not significantly different (P>0.05). The distance from the BF to the cranial or caudal endplate in the saggital CT images were significantly different (P<0.05). The distance from the BF to the cranial endplate was shorter than to the caudal endplate.　Conclusion　For clinic operators, the knowledge of anatomic distribution of BF and VV in vertebral bodies helps to reduce the occurrence of bone cement leakage in PVP and PKP.