青少年中上胸椎的影像解剖学特点.doc

青少年中上胸椎的影像解剖学特点张志峰1，史 君2，魏 晶3，王 星4，郑雷刚5，霍洪军1，李志军4内蒙古医科大学第二附属医院，1关节科，3手外科，内蒙古自治区呼和浩特市 010030；内蒙古医科大学基础医学院，2生理教研室，4人体解剖教研室，内蒙古自治区呼和浩特市 010110；5内蒙古自治区中医院骨科，内蒙古自治区呼和浩特市 010020Radiographic anatomy features of teenagers upper-middle thoracic vertebraeZhang Zhi-feng1, Shi Jun2, Wei Jing3, Wang Xing4, Zheng Lei-gang5, Huo Hong-jun1, Li Zhi-jun41 Joint Surgical Department, 3 Department of Hand Microsurgery, The Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China; 2 Physiological Teaching and Research Section, 4 Teaching and Research Section of Human Anatomy, Basic Medical College, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; 5 Department of Orthopedics, Inner Mongolia Hospital of Traditional Chinese Medicine, Hohhot 010020, Inner Mongolia Autonomous Region, China摘要 背景：处于发育高峰的青少年和成人骨骼情况存在较大差异，若以成人的标准去置钉青少年群体则有较大危险性。目的：观测青少年中上胸椎影像解剖学特点，为青少年中上胸椎经椎弓根置钉及经椎弓根-肋头单元置钉提供实验依据。方法：将30例无脊柱区病变青少年(13-18周岁)T1-T12节段行CT扫描(0.625-1.25 mm)后，原始数据以DICOM格式导入三维重建软件进行相关指标测量，按不同节段进行统计分析。结果与结论：椎弓根宽和椎弓根-肋头单元宽的总体走势接近，均呈“V”型，最小值位于T4处，并且两者之间相对应椎体的差异有显著性意义(P 0.05)；椎弓根钉道长度和椎弓根-肋头单元钉道长度之间其走势基本一致，均呈逐渐递增趋势，最小值为T1，最大值位于T10处，二者之间相对应的椎体间差异均有显著性意义(P 0.05)；椎弓根横断面角与椎弓根-肋头单元横断面角的走势相似，T1-T10总体也呈下降趋势，并且与各相应椎骨间差异均有显著性意义(P 0.05)；椎弓根矢状面角与椎弓根-肋头单元矢状面角的曲线走势基本相近，均呈波浪型，并且与各相应椎骨间差异均有显著性意义(P 0.05)。提示相同节段的椎弓根-肋头单元可以提供较椎弓根相对安全的置钉钉道。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：窗体顶端关键词 ： 植入物； 数字化骨科； 胸椎； 椎弓根； 椎弓根-肋头单元； 三维重建； 影像测量； 螺钉植入； 青少年； 国家自然科学基金； Abstract： BACKGROUND: The conditions of teenager and adult skeletons have great differences. Thus, it is dangerous to place screw on teenagers using the methods for adults. OBJECTIVE: To observe the anatomical features of teenagers upper-middle thoracic vertebra images, and to provide experimental basis for pedicle nailing and pedicle-rib head unit nailing in teenagers upper-middle thoracic vertebrae. METHODS: We chose 30 teenagers (13 to 18 years old) without spine lesions, and then they were scanned (0.625-1.25 mm) from T1 to T12 segments using CT. The original data were loaded into a three dimensional software in DICOM format for measuring related indicators. At last, we analyzed the data according to different segments. RESULTS AND CONCLUSION: The trend between the width of pedicle and pedicle-head unit was similar, showing a “V” shape. The minimum of width was located in the T4, and there were significant differences between the corresponding vertebral bodies (P 0.05). The trend between pedicle nail road length and pedicle-rib head unit nail road length was similar, and the trend between them was gradually increasing. The minimum of length was located in T1, and the maximum of length was located at T10, and there were significant differences between the corresponding vertebral bodies (P 0.05). The trend between the pedicle transverse angle and pedicle rib-head unit transverse angle was similar. The trend from T1 to T10 was on a decline, and there were significant differences in corresponding vertebrae (P 0.05). The trend of curves between pedicle sagittal angle and pedicle rib-head unit sagittal angle was similar, showing a wavy shape, and there were significant differences in corresponding vertebrae (P 0.05). These results confirmed that the same segmental pedicle rib-head unit can provide a safer nailing place than the pedicle relatively.中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：Key words： thoracic vertebrae; image processing, computer-assisted; bone nails; prostheses and implants; 窗体底端 中图分类号:R