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目的研究皮质骨通道(CBT)置腰椎椎弓根螺钉内固定技术中螺钉的参数,为临床应用提供帮助。方法连续收集正常人群的腰椎CT影像片,利用计算机软件测量L1~L5各节段左右侧进钉点、进钉轨道的头倾角和外倾角、螺钉直径和长度,比较不同腰椎节段上述参数的差异。结果共选取腰椎正常的受试者36例,其中男女各18例。测量结果显示各节段CBT螺钉的头倾角和外倾角差异无显著性;L1~L5各节段CBT的直径分别为(6.6±1.5)mm,(7.6±2.0)mm,(7.6±0.8)mm,(8.6±1.3)mm和(8.6±1.8)mm,其中L4和L5节段螺钉直径显著大于L1节段(P分别为0.020和0.031);L1~L5各节段CBT的长度分别为28.2(26.0,30.8)mm,30.9(20.4,39.6)mm,32.8(22.2,39.3)mm,46.7(26.3,49.4)mm和50.0(30.0,52.6)mm,L1节段螺钉长度显著短于L2~L5节段(P分别为0.008,0.027,0.008和0.012),L2节段长度短于L4和L5节段(P分别为0.035和0.047);男性L2~L5节段螺钉的测量直径均大于女性(P值分别为0.042,0.041,0.035和0.037),L2,L3和L5节段螺钉长度显著长于女性(P分别为0.017,0.043和0.026)。结论正常成人腰椎CBT螺钉的直径和长度从L1到L5有增大趋势,同一腰椎节段,男性CBT螺钉的直径和长度较女性有增大趋势。
Objective To study the parameters of screw fixation in cortical bone channel (CBT) for lumbar pedicle screw fixation, and to provide help for clinical application. Methods CT images of lumbar spine were collected continuously in the normal population. The left and right side of L1 ~ L5 were measured by computer software. The inclinations, camber angles, screw diameters and lengths of the nails were measured. The above parameters of different lumbar segments were compared difference. Results A total of 36 subjects with normal lumbar spine were selected, including 18 males and 18 females. The results showed that there was no significant difference in the incline angle and camber between CBT screws in each segment. The diameters of CBT in segments L1 ~ L5 were (6.6 ± 1.5) mm, (7.6 ± 2.0) mm, (7.6 ± 0.8) mm , (8.6 ± 1.3) mm and (8.6 ± 1.8) mm, respectively. The diameter of screw in L4 and L5 segments was significantly larger than that in L1 segment (P = 0.020 and 0.031, respectively); the lengths of CBT in L1 ~ L5 segments were 28.2 The length of L1 segment was significantly shorter than that of L2 ~ L5 segment (P <0.05), while the length of L1 segment was significantly shorter than that of L2 ~ L5 segment (30.0,5.2.6) mm, 30.9 (20.4,39.6) mm, 32.8 (22.2,39.3) mm, 46.7 (26.3,49.4) mm and 50.0 (P = 0.008, 0.027, 0.008 and 0.012, respectively). The length of L2 segment was shorter than that of L4 and L5 segments (P = 0.035 and 0.047, respectively) 0.042, 0.041, 0.035 and 0.037, respectively). The lengths of the screws in L2, L3 and L5 segments were significantly longer than those in females (P = 0.017,0.043 and 0.026, respectively). Conclusions The diameters and lengths of CBT screws in normal adults tend to increase from L1 to L5. The diameters and lengths of male CBT screws in the same lumbar segment increase more than those in women.