椎弓根钉━髂骨钉系统内固定治疗骶髋关节脱位的CT影像解剖学研究

杨运平; 陈鸿奋; 王富明; 贾谊; 王钢

中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (4) : 404-407.

断层影像解剖

椎弓根钉━髂骨钉系统内固定治疗骶髋关节脱位的CT影像解剖学研究

杨运平，陈鸿奋，王富明，贾谊，王钢

作者信息 +

The pedicle and iliac screw fixation in treatment of sacroiliac dislocation and fracture: CT tomography study

YANG Yun-ping, CHEN Hong-feng, WANG Fu-ming, JIA Yi, WANG Gang

Author information +

文章历史 +

摘要

目的探讨基于CT数据建立腰-骶-髂复合体的数字模型，应用数字骨科技术为临床上采用联合椎弓根钉-髂骨钉系统内固定治疗骶髂关节骨折脱位提供理论依据。方法采用40例正常骨盆CT平扫数据，用mimics10.0软件进行三维图像重建，并在虚拟的髂骨上模拟髂骨钉的置入，测量不同进钉方向时进钉角度及髂骨钉的解剖参数。结果进钉方向Ⅰ：髂骨内外板之间的距离（即容纳髂骨螺钉的最大直径）（6.00±0.84）mm，能置入螺钉的长度（59.97±7.99）mm，TSA（12.48±7.16）°，CSA（56.41±　6.47）°，SSA（29.91±5.55）°。进钉方向Ⅱ：髂骨内外板之间的距离（即容纳髂骨螺钉的最大直径）（6.95±　0.50）mm，能置入螺钉的长度（106.69±8.74）mm，TSA（43.93±6.09）°，CSA（39.25±6.11）°，SSA（19.24±　3.78）°。结论　数字骨科模型能更好的指导临床上采用椎弓根钉系统治疗骶髋关节脱位。

Abstract

Objective To investigate the value of digital model on evaluating pedicle screw and iliac screw in treating sacroiliac dislocation and fracture. Methods The pelvic CT data from 40 healthy adults were imported into the Mimics 10.0 software for three-dimensional reconstructing of pelvis. The anatomic parameters concerning with inserting angles and the ilium screws at different directions were measured on the virtual pelvis. Results The distance between lateral and medial ilium lamella（the maximum diameter of ilium screw）was about（6.00±0.84）mm，or （6.95±0.50）mm. The length of screw inserting was （59.97±7.99）mm，or （106.69±8.74）mm. TSA was （12.48±7.16）° or （43.93±6.09）°，CSA（56.41±6.47）° or （39.25±6.11）°，and SSA（29.91±5.55）° or 19.24±3.78）° at the different inserting direction, respectively. Conclusions Digital pelvic model is a valuable tool to guide clinical treatment of sacroiliac dislocation and fracture through pedicle screw and iliac screws.

导出引用

杨运平, 陈鸿奋, 王富明, 贾谊, 王钢. 椎弓根钉━髂骨钉系统内固定治疗骶髋关节脱位的CT影像解剖学研究[J]. 中国临床解剖学杂志. 2012, 30(4): 404-407

YANG Yun-Beng, CHEN Hong-Fen, WANG Fu-Meng, GU Yi, WANG Gang. The pedicle and iliac screw fixation in treatment of sacroiliac dislocation and fracture: CT tomography study[J]. Chinese Journal of Clinical Anatomy. 2012, 30(4): 404-407

中图分类号： R683.3

参考文献

[1] Allen BJ, Ferguson RL. The Galveston technique for L rod instrumentation of the scoliotic spine
[J]. Spine,1982, 7(3):276-284.

[2] Starr AJ, Griffin DR, Reinert CM, et al. Pelvic ring disruptions: prediction of associated injuries, transfusion requirement, pelvic arteriography, complications, and mortality
[J]. J Orthop Trauma,2002,16(8):553-561.

[3] Dabezies EJ, Millet CW, Murphy CP, et al. Stabilization of sacroiliac joint disruption with threaded compression rods
[J]. Clin Orthop Relat Res, 1989，(246):165-171.

[4] 任义军，王钢，裴国献，等. 骶髂关节脱位直视复位空心螺钉固定解剖学及临床应用
[J]. 中国临床解剖学杂志,2007，25(1):92-94.

[5] Routt MJ, Simonian PT, Mills WJ. Iliosacral screw fixation: early complications of the percutaneous technique
[J]. J Orthop Trauma,1997,11(8):584-589.

[6] Bijlsma TS, Van der Werken C, Fernandez DA. Transperitoneal screw fixation of the sacroiliac joint
[J]. J Trauma, 2000, 49(1):152-155.

[7] Sar C, Kilicoglu O. S1 pediculoiliac screw fixation in instabilities of the sacroiliac complex: biomechanical study and report of two cases
[J]. J Orthop Trauma, 2003, 17(4):262-270.

[8] Korovessis P, Stamatakis M, Baikousis A. Posterior stabilization of unstable sacroiliac injuries with the Texas Scottish Rite Hospital spinal instrumentation
[J]. Orthopedics,2000,23(4):323-327.

[9] Van Savage JG, Dahners LE, Renner JB, et al. Fracture-dislocation of the lumbosacral spine: case report and review of the literature
[J]. J Trauma,1992, 33(5):779-784.

[10]Gokaslan ZL，Romsdahl MM，Kroll SS, et al. Total sacrectomy and galveston L-rod reconstruction for malignant neoplasms. Technical note
[J]. J Neurosurg, 1997, 87(5): 781-787.

[11]Berry JL, Stahurski T, Asher MA. Morphometry of the supra sciatic notch intrailiac implant anchor passage
[J]. Spine, 2001, 26(7):E143-E148.

[12]Krag MH, Van Hal ME, Beynnon BD. Placement of transpedicular vertebral screws close to anterior vertebral cortex. Description of methods
[J]. Spine,1989,14(8):879-883.