基于中国人腰骶区解剖参数不同轨迹螺钉的影像学研究

doi:10.3969/j.issn.1006-7795.2021.04.023

摘要/Abstract

摘要： 目的通过对骶骨CT扫描资料进行三维重建,描述S1椎弓根螺钉(pedicle screw, PS)、S1皮质骨螺钉(cortical screw, CS)以及骶骨翼螺钉(sacral alar screw, SAS)3种内固定方式的影像学参数并进行对比分析其可靠程度。方法收集2019年1月至2019年12月至首都医科大学附属北京朝阳医院行腰骶段计算机断层扫描(computed tomography,CT)三维扫描的非骨科疾病中国人受试者CT资料。共获得42例受试者数据,其中男性20例,女性22例,平均年龄为(55.14±8.35)岁。将资料导入MIMICS软件进行三维重建,测量S1骶骨翼螺钉钉道、皮质骨螺钉钉道及椎弓根螺钉钉道的最大长度、外展角、尾倾角与平均CT值。结果 S1骶骨翼螺钉最长钉道外展(63.51±8.68)°,尾倾角(36.62±10.97)°,长度(41.74±3.33)mm;S1皮质骨螺钉最长钉道轨迹外展(5.62±3.69)°,头倾角(6.60±4.88)°,长度(31.60±4.23)mm;S1椎弓根螺钉最长钉道内收(29.42±3.89)°,尾倾角(15.60±6.58)°,长度(48.12±5.44)mm。S1椎弓根螺钉长度显著大于骶骨翼螺钉与皮质骨螺钉,而骶骨翼螺钉的平均CT值显著高于椎弓根螺钉,但骶骨翼螺钉钉道中点区域的CT值较另两种钉道显著更低(P＜0.001)。结论 S1骶骨翼螺钉应用于骶骨固定是可行的,其钉道长度大于同节段皮质骨螺钉轨迹,钉道平均CT值大于椎弓根螺钉轨迹,可以作为短节段腰骶固定的替代方式之一,但还需要生物力学研究的进一步验证。

关键词: 影像学测量, 腰骶部固定, 骶骨翼螺钉, 皮质骨螺钉, 椎弓根螺钉

Abstract: Objective To describe and compare the radiological parameters of S1 pedicle screw (PS), S1 cortical screw (CS)and sacral alar screw (SAS) utilizing the three-dimensional reconstruction of sacralcomputed tomography (CT) scan data. Methods The CT data of Chinese patients with non-orthopedic diseases who received three-dimensional CT scan of the lumbosacral segment from January 2019 to December 2019 in our hospital will be collected. A total of 42 patients were obtained, including 20 males and 22 females, with an average age of (55.14±8.35) years old. To import all CT data into MIMICS software for three-dimensional reconstruction, and measure the maximum length, transverse angle (TA), sagittal angle (SA), and average CT value of S1 SAS, CS, and PS trajectory will be done. Results The TA of the longest S1 SAS is (63.51±8.68)°, the SA is(36.62±10.97)°, the length is (41.74±3.33)mm; the TA of the longest S1 CS is about (5.62±3.69)°, the SA is about (6.60±4.88)°, the length is (31.60±4.23)mm; the TA of the longest S1 PS is (29.42±3.89)°, the SA is (15.60±6.58)°, and the length is (48.12±5.44)mm. The length of S1 PS was significantly longer than that of SAS and CS, and the average CT value of SAS was significantly higher than that of PS, but the CT value in the midpoint of SAS trajectory was significantly lower than that of CS and PS. Conclusion It is feasible for S1 sacral alar screw to be used in sacral fixation. The length of screw trajectory is longer than that of cortical screw in the same segment, and the average CT value of screw trajectory is higher than that of pedicle screw, which can be used as one of the alternatives for short segment lumbosacral fixation. However, biomechanical studies are needed to further verify the results.

Key words: radiological measurement, lumbosacral fixation, sacral alar screw, cortical screw, pedicle screw

中图分类号:

R681

丁红涛, 刘玉增, 海涌, 关立, 潘爱星, 张希诺, 韩渤, 李越. 基于中国人腰骶区解剖参数不同轨迹螺钉的影像学研究[J]. 首都医科大学学报, 2021, 42(4): 653-659.

Ding Hongtao, Liu Yuzeng, Hai Yong, Guan Li, Pan Aixing, Zhang Xinuo, Han Bo, Li Yue. Radiological study of different sacral S1 screw trajectories based on the anatomical parameters of the Chinese population[J]. Journal of Capital Medical University, 2021, 42(4): 653-659.

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