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以上关节突确定正常成人胸椎椎弓根置钉参数的影像学测量.doc

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1、 : , , , , , , , : CT : 30 CT , T1-T12 CT : (1) : , , ; (2) : , ; (3) : , , : (1) CT , T1-T12 ; (2) :T1-T12 mm (P=0.343, 0.214, 0.467) ; (3) :T1-T12 mm (91.7 (P=0.073, 0.084, 0.310, 0.265, 0.241, 0.175) ; (4) , , , ; ; ; ; ; ; ; CT; ; ; ; , , 1975 , , , 2000 , , , ORCID:0000-0001-9245-5587 , , , , 4

2、10013 (2016KJ45) Determination of thoracic pedicle screw parameters by superior facet in normal adults: an imaging study Lu Zheng-hao Li Ji-peng Zhou Jing-hua Wang Wei-guo Department of Spinal Surgery, Nanhua Hospital Affiliated to South China University; Department Department of Radiology, Nanhua H

3、ospital Affiliated to South China University; Department of Orthopedics, the Third Xiangya Hospital, Central South University; Abstract BACKGROUND: In the existing thoracic pedicle screw fixation technique, superior facet or combined with transverse process and the imaginary transverse and sagittal

4、section are used as the reference mark of pedicle screw entry point and angle, respectively, which still remain controversial. Because of the effect of position deviation and subjective judgment during surgery, screw misplacement and severe complications often occur, which limit the clinical applica

5、tion and promotion of the technique. At present, it is very important to select a single bony mark, which is not affected by the patients position, and is easy to judge, as the reference mark of screw entry point and angle. OBJECTIVE: To explore the feasibility of taking superior facet as a single b

6、ony mark to determine thoracic pedicle screw parameters in normal adults by measuring 3 D reconstruction CT image and its corresponding relationships. METHODS: 3 D reconstruction CT images of the thoracic spine in 30 normal adults were selected and the basic parameters, entry angle parameters and en

7、try depth parameters were directly determined on specific reconstructed CT images of T1-T12.The basic parameters included the vertical distance from the entry point to the midline, the vertical distance from the outer edge of superior facet to the midline and superior facet base width. Entry point p

8、arameters were indirectly calculated by the basic parameters, including transversal point-facet distance, entry point ratio and sagittal point-facet distance, which was the horizontal distance from entry point to outer edge of superior facet, the ratio of transversal point-facet distance to superior

9、 facet base width, and the longitudinal distance from entry point to the base of superior facet. Entry angle parameters included transversal axis-facet angle and sagittal axis-facet angle, which is the transversal and sagittal angle between the axis of pedicle and the surface of facet. Entry depth p

10、arameter included safety screw length, which is the distance from entry point to anterior vertebral cortex along the axis of pedicle. Mean and standard deviation were counted and statistics difference was compared. RESULTS AND CONCLUSION: (1) Using CT technology of 3 D reconstruction, T1-T12 thoraci

11、c transversal section through bilateral pedicle axis, transversal section through the base of the superior facet, which parallel to the bilateral pedicle axis, and oblique sagittal section through homolateral pedicle axis were successfully obtained. (2) The statistical results of the basic parameter

12、s were as follows: the left and right vertical distances between T1-T12 from the vertical distance from the outer edge of superior facet to the midline t base width were difference in the measured values between two sides of the above parameters (P=0.343, 0.214, 0.467) . (3) The statistical results

13、of pedicle screw parameters were as follows: the left and right transversal point-facet distance between T1- point- axis-facet angle w axis- significant difference in the measured values between two sides of the above parameters (P=0.073, 0.084, 0.310, 0.265, 0.241, 0.175) . (4) These results indica

14、te that taking thoracic superior facet as a single anatomic landmark to determine pedicle screw parameters is simple and feasible in normal adults, and they correlate with each other, which can be used as a new method for choosing screw parameters. : : : , , , , , , , , : , , , , , 0 Introduction 1-

15、2, , , 3 , , , 4-6 , , 7-9 Roy-camille 10 1986 , :Roy-camille Louis Vaccaro Ebraheim Kim , , , , , , , 11-13 , 3 , , , , , , , , , , , 14-15 , , , , , , , , CT T1-T12 , , 1 Subjects and methods 1.1 1.2 2016 8 2017 2 1.3 2016 8 2017 2 30 , 14 , 16 ; 21-66 , 44.3 ; : 8 , 13 , 7 , 2 : (1) 18 ; (2) CT :

16、 (1) / ; (2) ; (3) 1.4 1.4.1 CT GE 64 CT : , , :C7-L1 : , 0.6 s, 5 mm, 5 mm, 120 k V, , 20 cm 1.4.2 CT T1-T12 1.25 mm 0.625 mm , AW4.6 (GE ) CT , : (1) ( 1A) , 1 mm 1 mm 25 20 cm ( 1B) ( 1C) ; (2) ( 1D) ( ) , ( 1E) 1.4.3 ( 2, 0.1 mm, (1) ( 2A) : (1) : ; (2) : (2) ( 2B) : (1) : ; (2) : ; (3) : (3) (

17、2C) , 2 3 , 3 , : (1) = - ; (2) = / ; (3) = ( 2A - 2B , , , , 1.5 1.5.1 1.5.2 (1) : ; (2) : ; (3) : 1 CT Figure 1 Methods of obtaining CT images for measurement : ( T5 ) CT T5 ( A) , ( B) ( C) ( ) ( D) , ( E) 2 CT Figure 2 Diagram of parameters measured on the CT image : ( T5 ) m, a b A B a b ( A) , A m, ( ) C D, ( )

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