经皮椎板关节突螺钉固定的应用解剖及影像学研究

目的]为经皮椎板关节突螺钉的器械设计及临床应用提供解剖学依据。方法]利用30例干燥腰椎标本，用游标卡尺及量角器测量腰椎椎板上缘及下缘的厚度，椎板关节突螺钉的长度。通过影像学测量椎板的内倾角和下倾角。结果]椎板的上缘薄而下缘厚。从L1～5椎板的厚度、螺钉的长度及从内倾角逐渐增加，而下倾角逐渐减小。结论]上缘的厚度太薄不适合螺钉的放置。从L1～5使用4．5mm的皮质骨螺钉固定是安全的，但应该在椎板的下缘置人。注意下倾角和内倾角的变化。设计的瞄准器应该具有调节角度的装置。

Placement of percutaneous translaminar facet screw: an anatomic study

Objective] To provide anatomic basement for the clinic appliance of percutaneous tnranslammar facet screw. Method] From L1 to L5, anatomic measurements for screw path length, superior and inferior lamina border thickness in 30 dried lumbar spines, caudal and lateral angles of laminar were measured with CT and X ray. Result] The superior border of the lamina was relatively thinner from L1 to L5 , The thickness of the inferior border of the lamina, the mean values of the length of the screw path and lateral angle gradually increased, and the caudal angle of screw placement relative to transverse plane gradually decreased. Conclusion ] A translaminar facet screw with 4. 5 mm in diameter is safe. from L1-5. Screw should be inserted in inferior lamina border, not in the superior border of the lamina, caudal and lateral angles of laminar should be ajustable to fit the lumbar facet joint.