Complexity of the thoracic spine pedicle anatomy.
Complexity of the thoracic spine pedicle anatomy.
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DOI：
10.1007/bf01676570
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发表时间：
1997-01-01
期刊：
影响因子：
--
通讯作者：
Kothe, R
中科院分区：
文献类型：
--
作者：
Panjabi, M M;O'Holleran, J D;Kothe, R
经椎弓根螺钉固定可提供胸腰椎的刚性稳定。为了准确地将螺钉插入椎弓根并避免椎弓根皮质穿孔，需要更精确地了解椎弓根的解剖结构。本研究旨在以图形方式显示胸椎椎弓根的表面解剖结构和内部结构。使用了15个椎骨，平均分布在上、中、下胸椎区域。为了标测表面解剖结构，清洁每个椎弓根，喷涂白色，并标记100多个细点。使用光电数字化仪，将标记点和代表坐标系的另外三个点的三维坐标数字化。使用实体建模计算机程序创建椎弓根的三维表面图像。为了获得横截面信息，每个椎弓根用薄金刚石锯片锯切片，获得4个切片，厚度为1 mm，间隔为0.5 mm。对椎弓根切片进行X射线检查并投影到数字化仪上。内部和外部轮廓被计算机数字化并转换为图形。椎弓根在其形状和方向上表现出显著的变异性，不仅在胸椎内的不同区域，而且在同一区域内，甚至在同一椎弓根内。根据目前胸椎经椎弓根螺钉固定所使用的技术，这些变化是非常显著的。记录椎弓根解剖结构三维复杂性的信息对于外科医生和对脊柱内固定感兴趣的研究者来说是有价值的。
Transpedicular screw fixation provides rigid stabilization of the thoracolumbar spine. For accurate insertion of screws into the pedicles and to avoid pedicle cortex perforations, more precise knowledge of the anatomy of the pedicles is necessary. This study was designed to visualize graphically the surface anatomy and internal architecture of the pedicles of the thoracic spine. Fifteen vertebrae distributed equally among the upper, middle, and lower thoracic regions were used. For the purpose of mapping surface anatomy, each pedicle was cleaned, spray-painted white, and marked with more than 100 fine points. Using an optoelectronic digitizer, three-dimensional coordinates of the marked points and three additional points, representing a coordinate system, were digitized. A solid modeling computer program was used to create three-dimensional surface images of the pedicle. To obtain cross-sectional information, each pedicle was sectioned with a thin diamond-blade saw to obtain four slices, 1 mm in thickness and 0.5 mm apart. The pedicle slices were X-rayed and projected onto a digitizer. The internal and external contours were digitized and converted into graphs by a computer. The pedicles exhibited significant variability in their shape and orientation, not only from region to region within the thoracic spine, but also within the same region and even within the same pedicle. These variations are extremely significant in light of current techniques utilized in transpedicular screw fixation in the thoracic spine. Information documenting the three-dimensional complexity of pedicle anatomy should be valuable for surgeons and investigators interested in spinal instrumentation.