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目的:研究以腰椎人字嵴顶点椎弓根螺钉进钉点的解剖学基础。方法:在１００套成人干燥腰椎骨标本上对人字嵴的出现率、人字嵴顶点与椎弓根中心的关系进行了观测。结果:①腰椎人字嵴出现率为９４．８%。其中Ｌ１为９６．７%;Ｌ２为９８．９%;Ｌ３为１００%;Ｌ４为９９%;Ｌ５为８１%;②进钉角度:Ｌ１为５．１°±４．７°;Ｌ２为６．２°±３．７°;Ｌ３为７．５°±３．２°;Ｌ４为８．９°±３．３°;Ｌ５为１０．７°±７．９°。③进钉深度:Ｌ１为(４．３±０．３)ｃｍ;Ｌ２为(４．３±０．３)ｃｍ;Ｌ３为(４．５±０．４)ｃｍ;Ｌ４为(４．３±０．３)ｃｍ;Ｌ５为(４．１±０．３)ｃｍ。结论:①腰椎的人字嵴结构恒定存在,变异小,且不受退变影响;②人字嵴顶点位于或接近椎弓根中心,不需过多地显露横突和关节突关节,是一种简单、实用的进钉方法。
OBJECTIVE: To study the anatomic basis of pedicle screw insertion at vertex of lumbar crest. Methods: The incidence of crestal ridge, the apex of chevron ridge and the center of pedicle were measured in 100 sets of adult lumbar vertebrae specimens. Results: ① The incidence of spondylolisthesis was 94.8%. L1 is 96.7%; L2 is 98.9%; L3 is 100%; L4 is 99%; L5 is 81%; ② entry angle: L1 is 5.1 ° ± 4.7 °; L2 is 6 .2 ° ± 3.7 °; L3 7.5 ° ± 3.2 °; L4 8.9 ° ± 3.3 °; L5 10.7 ° ± 7.9 °. ③ The depth of nailing was (4.3 ± 0.3) cm for L1; (4.3 ± 0.3) cm for L2; (4.5 ± 0.4) cm for L3; (4.3 ± 0.3) cm; L5 was (4.1 ± 0.3) cm. Conclusions: ① The structure of lumbar spine crest is constant, the variation is small, and is not affected by degeneration; ② the crest of chevron is located at or near the center of pedicle, without excessive exposure of the transverse process and the articular process; A simple, practical approach to the nail.