CAJ | 학술논문

背景：处于发育高峰的青少年和成人骨骼情况存在较大差异，若以成人的标准去置钉青少年群体则有较大危险性。 　　目的：观测青少年中上胸椎影像解剖学特点，为青少年中上胸椎经椎弓根置钉及经椎弓根-肋头单元置钉提供实验依据。 　　方法：将30例无脊柱区病变青少年(13-18周岁)T 1-T 12节段行CT扫描(0.625-1.25 mm)后，原始数据以DICOM格式导入三维重建软件进行相关指标测量，按不同节段进行统计分析。 　　结果与结论：椎弓根宽和椎弓根-肋头单元宽的总体走势接近，均呈“V”型，最小值位于T 4处，并且两者之间相对应椎体的差异有显著性意义(P <0.05)；椎弓根钉道长度和椎弓根-肋头单元钉道长度之间其走势基本一致，均呈逐渐递增趋势，最小值为T 1，最大值位于T 10处，二者之间相对应的椎体间差异均有显著性意义(P<0.05)；椎弓根横断面角与椎弓根-肋头单元横断面角的走势相似，T 1-T 10总体也呈下降趋势，并且与各相应椎骨间差异均有显著性意义(P <0.05)；椎弓根矢状面角与椎弓根-肋头单元矢状面角的曲线走势基本相近，均呈波浪型，并且与各相应椎骨间差异均有显著性意义(P <0.05)。提示相同节段的椎弓根-肋头单元可以提供较椎弓根相对安全的置钉钉道。
배경：처우발육고봉적청소년화성인골격정황존재교대차이，약이성인적표준거치정청소년군체칙유교대위험성。 　　목적：관측청소년중상흉추영상해부학특점，위청소년중상흉추경추궁근치정급경추궁근-륵두단원치정제공실험의거。 　　방법：장30례무척주구병변청소년(13-18주세)T 1-T 12절단행CT소묘(0.625-1.25 mm)후，원시수거이DICOM격식도입삼유중건연건진행상관지표측량，안불동절단진행통계분석。 　　결과여결론：추궁근관화추궁근-륵두단원관적총체주세접근，균정“V”형，최소치위우T 4처，병차량자지간상대응추체적차이유현저성의의(P <0.05)；추궁근정도장도화추궁근-륵두단원정도장도지간기주세기본일치，균정축점체증추세，최소치위T 1，최대치위우T 10처，이자지간상대응적추체간차이균유현저성의의(P<0.05)；추궁근횡단면각여추궁근-륵두단원횡단면각적주세상사，T 1-T 10총체야정하강추세，병차여각상응추골간차이균유현저성의의(P <0.05)；추궁근시상면각여추궁근-륵두단원시상면각적곡선주세기본상근，균정파랑형，병차여각상응추골간차이균유현저성의의(P <0.05)。제시상동절단적추궁근-륵두단원가이제공교추궁근상대안전적치정정도。
BACKGROUND:The conditions of teenager and adult skeletons have great differences. Thus, it is dangerous to place screw on teenagers using the methods for adults. OBJECTIVE:To observe the anatomical features of teenagers’ upper-middle thoracic vertebra images, and to provide experimental basis for pedicle nailing and pedicle-rib head unit nailing in teenagers’ upper-middle thoracic vertebrae. METHODS:We chose 30 teenagers (13 to 18 years old) without spine lesions, and then they were scanned (0.625-1.25 mm) from T 1 to T 12 segments using CT. The original data were loaded into a three dimensional software in DICOM format for measuring related indicators. At last, we analyzed the data according to different segments. RESULTS AND CONCLUSION:The trend between the width of pedicle and pedicle-head unit was similar, showing a“V”shape. The minimum of width was located in the T 4 , and there were significant differences between the corresponding vertebral bodies (P<0.05). The trend between pedicle nail road length and pedicle-rib head unit nail road length was similar, and the trend between them was gradual y increasing. The minimum of length was located in T 1 , and the maximum of length was located at T 10 , and there were significant differences between the corresponding vertebral bodies (P<0.05). The trend between the pedicle transverse angle and pedicle rib-head unit transverse angle was similar. The trend from T1 to T10 was on a decline, and there were significant differences in corresponding vertebrae (P<0.05). The trend of curves between pedicle sagittal angle and pedicle rib-head unit sagittal angle was similar, showing a wavy shape, and there were significant differences in corresponding vertebrae (P<0.05). These results confirmed that the same segmental pedicle rib-head unit can provide a safer nailing place than the pedicle relatively.