目的 放射解剖学比较第1和第2骶骨翼-髂骨螺钉（S1AIS，S2AIS）固定骶髂关节的植入安全性。 方法 选择80例正常成人骨盆CT 数据。男女各40例；年龄（45.1±6.3）岁。利用CT数字重建技术模拟SAIS固定方法，三维重建骨盆测量S1AIS和S2AIS的可进针范围、钉道长度和宽度。在30个3D打印骨盆模型的左右侧分别植入Φ6.5 mm和Φ8.0 mm螺钉，观察螺钉植入情况。 结果 S1AIS和S2AIS的钉道长度和宽度相近（P>0.05），植入Φ6.5 mm SAIS均无钉道穿破。然而，S2AIS可进针范围和钉道骶骨侧长度[（234.56±10.06 ） mm2，（40.97±2.81） mm]均小于S1AIS[（307.55±10.42） mm2，（42.16±3.06） mm，P<0.05]，植入Φ8.0 mm S2AIS的骶骨后外侧皮质穿破率（30%）高于S1AIS（3%）（P<0.05）。 结论 S1AIS较S2AIS具有更大的可进针范围、更少的骶骨侧后外侧皮质穿破和更长的钉道骶骨侧长度，提示S1AIS比S2AIS固定骶髂关节具有更高植入安全性。
关键词：
骶骨翼-髂骨螺钉; ; ; 骶髂关节; ; ; 螺钉植入; ; ; 放射解剖; ; ; 安全性
Objective To compare the implantation safety of the first and second sacral alar-iliac screw (S1AIS, S2AIS) for fixation of sacroiliac joint through radiological anatomy. Methods CT data of 80 normal adult pelvic were selected, with 40 cases for each gender, aged (45.1±6.3) years old. By simulating the SAIS fixation method using CT digital reconstruction technology to measure the insertable range, nail path length and width of S1AIS and S2AIS on the 3D reconstruction of pelvic. Φ6.5 mm and Φ8.0 mm screws were implanted respectively on the left and right sides of 30 3D printed pelvic models. The implantation results were observed. Results The length and width of the nail path in S1AIS and S2AIS were similar (P>0.05), and there were no breaches of nail path in Φ6.5mm SAIS. However, the insertable range and the nail path length on the sacral side [(234.56±10.06) mm2, (40.97±2.81) mm] of S2AIS were smaller than those of S1AIS [(307.55±10.42) mm2, (42.16±3.06) mm, P<0.05], and the breach rate of the sacral posterior lateral cortex of Φ8.0 mm S2AIS (30%) was higher than that of Φ8.0 mm S1AIS (3%) (P<0.05). Conclusions S1AIS has a larger insertable range, fewer breaches of the sacral posterior lateral cortex and a longer nail path length on the sacral side compared to S2AIS, indicating that S1AIS has higher implantation safety than S2AIS in fixation of sacroiliac joint.
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