五种骶骨螺钉内固定的应用解剖研究

目的　评价五种骶骨内固定的安全性。方法　解剖七具尸体 ,以克氏针穿透模拟五种骶骨螺钉法 ,克氏针穿透骶椎前缘。分析骶骨螺钉损伤骶前重要结构的可能性 ,测量骶前安全区范围和螺钉钉道长度。结果　PTSF法螺钉不应穿透L5椎体前缘皮质 ,前外骶翼方向和垂直骶翼方向S1螺钉易损伤髂内动、静脉和腰骶干 ,前内骶岬方向S1螺钉的主要危险是骶正中血管 ,S2 螺钉易损及S1神经前支和交感链。结论　五种骶骨固定法均可损伤骶前重要结构 ,手术时应谨慎操作

Anatomy Study of Five Methods of Sacral Screw Fixation

Objective To evaluate the safety of five methods of sacral screw fixation Methods To anatomize seven bodies and use k wires imitating five methods of sacral screw fixation, the k wires penetrate the anterior wall of sacrum, the possibility of damage to the structures anterior to sacrum, the range of the safe zone of sacrum, the length of screws has been gauged and evaluated Results Pedical transvertebral screw(PTSF for short) should not penetrate the anterior L 5 vertebral body cortes,S 1 screws with the directions vertical of anterolateral to the iliac wing have a tendency to injury internal iliac vessels and lumbosacral trunk, S 1 screw which aims at sacral promontory is dangerous to middle sacral vessels,S 2 screw would damage anterior ramus of first sacral nerve and sympatheti trunk Conclusion All five methods of sacral screw can injuruy important structures anterior to sacrum Attention should be payed while oprative procedure