椎弓根螺钉内固定术有关角度测量及其临床意义

目的 :为椎弓根螺钉内固定术提供椎弓根相关角度的解剖学资料。方法 :在 10 0例脊柱骨标本 (C2 ～L5)上 ,测量椎弓根长轴与椎体矢状面及上平面之间的夹角。结果 :绝对值 :E角C4 ～C5最大 ,L5次之 ,而T12 最小 ,总体出现两个高峰一个低谷值 ;F角胸段均较大 ,其中T4 最大 ,颈段及腰段较小 ,呈典型的“山峰”形趋势 ;C2～L5的E角和F角侧别间差异均无显著性 (P <0 0 5 ) ,而性别间差异E角均为男大于女 ,C2 ～T6有显著性差异(P <0 .0 5 ) ,而T7～L5无显著性差异 (P >0 .0 5 ) ;F角除C3 、C4 女大于男且差异有显著性 (P <0 0 5 )外 ,其余均为男大于女 ,C2 、C5～T12 差异有极显著性 (P <0 0 1) ,而L1～L5则无显著性差异 (P >0 0 5 )。结论 :E角和F角值均有明显的规律性 ,参照E角F角及椎弓根的骨质结构确定相应的TSA角及SSA角。

THE MEASUREMENT OF PEDICLE ANGLE CONCERNED FOR TRANSPEDICULAR SCREW FIXATION AND ITS CLINICAL SIGNIFICANCE

Objective:To provide the anatomical data of pedicle angle concerned for transpedicular screw fixation.Methods:Morphologic observations and measurements have been taken from C2 to L5 on 100 intact skeletons including two angles that pedicle and sagittal plane and superior plane of vertebral body (E angle and F angle).Results:On absolute values,E angle of pedicle with C4-C5 were the maximum,next was L5 and T12 was the smallest.The E values from C2 to L5 showed the regularity of two "peak" and one "valley".The average values of F angle were bigger in thoracic region with T4 was the maximum,them were smaller in cervical region and lumbar region.The F angle values from C2 to L5 showed a typical shape of "mountain peak".There were no significant differences between two sides on E angles and F angles from C2 to L5 ( P >0.05),while difference on E angle did exist between sexes that from male being greater than that from female in C2-L5,with there were significant differences in C2-T6( P <0.05) and no significant difference in T7-L5(P >0.05).The difference on F angle did exist between sexes that from male being greater than that from female in C2-T12(not including C3 and C4),with there were significant differences in C3-C4( P <0.05)and extremely significant difference in C2,C5-T12( P <0.01),but no significant differences in L1-L5( P >0.05).Conclusion:There were a clear regularity on average values of E and F angles.When TSA and SSA were defined,these data could help operator to the screw with E angle,F angle and bone structure of pedicle screw channel.