腰椎峡部四边长度厚度的测量及临床意义
徐洪海, 邹庆洋, 张越林, 郭雄, 方海博, 刘宗智, 罗振群, 王晓庆, 李勇, 刘军, 任鹏宇, 马强, 祁洁
中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (3) : 261-264.
腰椎峡部四边长度厚度的测量及临床意义
The quadrilateral length and thickness of the Lumbar isthmus and clinical significance
目的 测量腰椎峡部四边长度及厚度,为椎板截取回植固定及“工”型钛板的设计提供解剖学依据。 方法 选取成人男性腰椎干燥骨32例,排除外观畸形和破损,游标卡尺及分规分别测量L1~L5峡部四边长度及厚度,并对其进行分析。 结果 (1)腰椎峡部上缘A长度范围L2:(6.47±0.90)mm~L5:(8.38±0.98)mm,L2~L5逐渐增加;腰椎峡部下缘C长度范围L1: (7.86±0.93)mm~L5:(4.77±0.64)mm,L1~L5逐渐减小;腰椎峡部内缘D长度范围L1:(19.07±0.86)mm~L5:(12.92±1.40)mm,L1最长,L5最短;腰椎峡部外缘B长度范围L3:(11.24±0.80)mm~L4:(9.87±0.65)mm,L3最长,L4最短。(2)外缘与上缘交点E厚度范围L1:(6.10±0.23)mm~L3:(7.53±0.35)mm,L3最厚,L1最薄;上缘与内缘交点F厚度范围L1:(5.10±0.25) mm~L3: (6.41±0.27)mm,L3最厚,L1最薄;下缘与内缘交点G厚度范围L1:(7.51±0.42)mm~L5:(6.25±0.27) mm,L1~L5逐渐变薄;外缘与下缘交点H厚度范围L1:(8.59±0.30)mm~L5:(10.11±0.35)mm,L1~L5逐渐增厚。 结论 为腰椎间盘突出症等椎板截骨回植术确定了最佳截骨部位:距腰椎峡部外缘3~4 mm,与内外缘平行;设计的“工”型钛板厚度1.2 mm,上边长9 mm,下边长10 mm,高度10 mm;微型螺钉长度为6、8、10、12 mm四种规格,直径2 mm。
Objective To measure the quadrilateral length and thickness of the Lumbar isthmus in order to provide the practical anatomy data for the lamina osteotomy replantation and for the design of a "工" shaped titanium plate. Method The length and thickness of the isthmus of 32 dried adult male's lumbar spines were directly measured from L1 to L5 with a vernier caliper and dividers, excluding the appearances of malformations and breakage. Results (1)The length of the superior(A) edge of the Lumbar isthmus gradually increased from L2 to L5 (from 6.47±0.90 mm at L2 to 8.38±0.98mm at L5),and that of the inferior(C) edge progressively decreased from L1 to L5 (from 7.86±0.93 mm at L1 to 4.77±0.64 mm at L5); The medial (D) edge of the isthmus from 19.07±0.86 mm at L1, the longest, to 12.92±1.40mm at L5, the shortest; The lateral(B) edge of the isthmus from 11.24±0.80 mm at L3, the longest, to 9.87±0.65 mm at L4, the shortest; (2) The thickness of the intersection E between the lateral edge and the superior edge ranges from 6.10±0.23 mm at L1, the thinnest, to 7.53±0.35mm at L3, the thickest; The thickness of the intersection F between the lateral edge and the medial edge ranges from 5.10±0.25 mm at L1, the thinnest, to 6.41±0.27 mm at L3, the thickest; The thickness of the intersection G between the inferior edge and the medial edge gradually decreases from L1 to L5 (from 7.51±0.42mm at L1 to 6.25±0.27mm at L3); The thickness of the intersection H between the lateral edge and the inferior edge gradually increases from L1 to L5 (from 8.59±0.30 mm at L1 to 10.11±0.35 mm at L5). Conclusion The study further reveals the Lumbar isthmus quadrilateral anatomical parameters. The best part of the Lumbar isthmus Osteotomy is at 3 ~ 4 mm from the lateral edge of the isthmus. It is in parallel with the medial and lateral edges. The thickness of the "工" shaped titanium plate is 1.2 mm, the length of the upper side is 9mm, the length of the lower side is 10mm, and the height is10 mm.The lengths of the miniature screws are 6 、8、10, and 12 mm, while the diameter is 2 mm.
Lumbar / Isthmus / Measurement / Application
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陕西省科技计划项目(2001K10-G9);西安市科技计划项目(HM1121(1));陕西省科学技术研究发展计划项目(2011K14-08-02)
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