上胸椎后路椎板螺钉固定的可行性研究
wf(2016)
Abstract
目的:了解国人上胸椎椎板的解剖学参数,探讨对国人进行上胸椎后路椎板螺钉固定的可行性。方法:选择40具国人成人尸体 T1~T4标本,用游标卡尺和量角器测量与上胸椎椎板螺钉进钉技术相关的解剖参数,包括椎板上、中、下部分的厚度和椎板高度、椎板钉道长度、椎板轴线与矢状面的夹角。结果:20具成人女性尸体 T4椎板中部分厚度、T1~T4椎板轴线与矢状面轴线的夹角与男性比较,差异均无统计学意义[(5.94±0.13)mm,(6.00±0.22)mm,t =1.609,P =0.112;46.00°±1.10°,46.50°±1.10°,t =1.955,P =0.054;46.30°±0.80°,46.60°±1.10°,t =1.383,P =0.171;45.40°±1.40°,45.30°±1.40°,t =0.404,P =0.688;45.20°±1.40°,45.30°±1.40°,t =0.410,P =0.683]。成人女性尸体 T1~T3椎板中部分厚度小于男性[(5.86±0.10)mm,(5.93±0.18)mm,t =2.083,P =0.040;(5.88±0.11)mm,(5.97±0.20)mm,t =2.581,P =0.012;(5.90±0.09)mm,(6.00±0.19)mm,t =2.885,P =0.006];T1~T4椎板上部分厚度、椎板下部分厚度、椎板高度、椎板钉道长度均小于男性[椎板上部分厚度:(5.39±0.12)mm,(5.51±0.13)mm,t =4.202,P =0.000;(5.43±0.09)mm,(5.52±0.11)mm,t =4.184,P =0.000;(5.43±0.10)mm,(5.53±0.10)mm,t =4.279,P =0.000;(5.41±0.08)mm,(5.53±0.07)mm,t =7.557,P =0.000;椎板下部分厚度:(5.43±0.12)mm,(5.55±0.12)mm,t =4.513,P =0.000;(5.43±0.07)mm,(5.57±0.10)mm,t =7.068,P =0.000;(5.44±0.08)mm,(5.57±0.11)mm,t =6.182,P =0.000;(5.44±0.07)mm,(5.58±0.09)mm,t =7.353,P =0.000;椎板高度:(16.86±0.50)mm,(18.64±0.71)mm,t =13.028,P =0.000;(16.89±0.62)mm,(19.22±0.76)mm,t =15.150,P =0.000;(17.22±0.52)mm,(20.09±0.92)mm,t =17.179,P =0.000;(17.45±0.59)mm,(21.10±0.95)mm,t =14.976,P =0.000;椎板钉道长度:(29.23±1.24)mm,(31.43±2.01)mm,t =5.898,P =0.000;(29.77±1.48)mm,(31.29±2.44)mm,t =3.358,P =0.000;(29.58±1.50)mm,(30.68±2.25)mm,t =2.590,P =0.000;(29.94±1.48)mm,(30.69±2.05)mm,t =1.873,P =0.000]。结论:对国人进行上胸椎后路椎板螺钉固定在解剖学上具有可行性,该方法可以作为下颈椎后路固定技术的补充。
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Key words
thoracic vertebrae,vertebral plate,internal fixators,anatomy,feasibility studies
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