中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2014年
11期
852-855
,共4页
椎间盘%刮除术%解剖学%尸体解剖
椎間盤%颳除術%解剖學%尸體解剖
추간반%괄제술%해부학%시체해부
Intervertebral disc%Curettage%Anatomy%Autopsy
目的：探讨经偏斜的椎弓根该通道行椎间盘髓核摘除的可行性。方法选取6具成人尸体脊柱标本，取 T10以下8个节段建立达上位椎间盘的椎弓根通道，描记可刮除的椎间盘范围并进行图像处理，计算每个椎间盘被刮除的面积占该节段椎间盘总面积的比值，再分别计算前、后部椎间盘被刮除的面积各占前部及后部的比值。结果可刮除面积占总面积的百分比从T10～11到L4～5依次为(16.96±0.54)%、(21.67±0.26)%、(21.52±1.13)%、(21.96±0.87)%、(22.64±1.04)%、(26.51±1.02)%、(33.87±1.32)%，趋势为逐渐递增，到L5～S1又明显减低，为(24.28±1.24)%。前、后可刮除面积占前、后总面积百分比的分析结果为：T10～11前方比值(15.40±1.62)%，后方比值(24.57±0.60)%；T11~12前方比值(20.75±0.86)%，后方比值(23.96±1.18)%；T12～L1前方比值(17.77±1.36)%，后方比值(24.33±1.08)%；L1～2前方比值(20.22±1.42)%，后方比值(25.06±1.22)%；L2～3前方比值(21.55±0.25)%，后方比值(22.26±0.85)%，后方比值均大于前方比值，但差异无统计学意义(P＞0.05)。结论经偏斜的椎弓根通道到达上位椎间盘，行T10～11到L4～5节段椎间盘髓核摘除，具有可操作性，其中L4～5间隙在该椎弓根通道下摘除髓核的可操作性最大。
目的：探討經偏斜的椎弓根該通道行椎間盤髓覈摘除的可行性。方法選取6具成人尸體脊柱標本，取 T10以下8箇節段建立達上位椎間盤的椎弓根通道，描記可颳除的椎間盤範圍併進行圖像處理，計算每箇椎間盤被颳除的麵積佔該節段椎間盤總麵積的比值，再分彆計算前、後部椎間盤被颳除的麵積各佔前部及後部的比值。結果可颳除麵積佔總麵積的百分比從T10～11到L4～5依次為(16.96±0.54)%、(21.67±0.26)%、(21.52±1.13)%、(21.96±0.87)%、(22.64±1.04)%、(26.51±1.02)%、(33.87±1.32)%，趨勢為逐漸遞增，到L5～S1又明顯減低，為(24.28±1.24)%。前、後可颳除麵積佔前、後總麵積百分比的分析結果為：T10～11前方比值(15.40±1.62)%，後方比值(24.57±0.60)%；T11~12前方比值(20.75±0.86)%，後方比值(23.96±1.18)%；T12～L1前方比值(17.77±1.36)%，後方比值(24.33±1.08)%；L1～2前方比值(20.22±1.42)%，後方比值(25.06±1.22)%；L2～3前方比值(21.55±0.25)%，後方比值(22.26±0.85)%，後方比值均大于前方比值，但差異無統計學意義(P＞0.05)。結論經偏斜的椎弓根通道到達上位椎間盤，行T10～11到L4～5節段椎間盤髓覈摘除，具有可操作性，其中L4～5間隙在該椎弓根通道下摘除髓覈的可操作性最大。
목적：탐토경편사적추궁근해통도행추간반수핵적제적가행성。방법선취6구성인시체척주표본，취 T10이하8개절단건립체상위추간반적추궁근통도，묘기가괄제적추간반범위병진행도상처리，계산매개추간반피괄제적면적점해절단추간반총면적적비치，재분별계산전、후부추간반피괄제적면적각점전부급후부적비치。결과가괄제면적점총면적적백분비종T10～11도L4～5의차위(16.96±0.54)%、(21.67±0.26)%、(21.52±1.13)%、(21.96±0.87)%、(22.64±1.04)%、(26.51±1.02)%、(33.87±1.32)%，추세위축점체증，도L5～S1우명현감저，위(24.28±1.24)%。전、후가괄제면적점전、후총면적백분비적분석결과위：T10～11전방비치(15.40±1.62)%，후방비치(24.57±0.60)%；T11~12전방비치(20.75±0.86)%，후방비치(23.96±1.18)%；T12～L1전방비치(17.77±1.36)%，후방비치(24.33±1.08)%；L1～2전방비치(20.22±1.42)%，후방비치(25.06±1.22)%；L2～3전방비치(21.55±0.25)%，후방비치(22.26±0.85)%，후방비치균대우전방비치，단차이무통계학의의(P＞0.05)。결론경편사적추궁근통도도체상위추간반，행T10～11도L4～5절단추간반수핵적제，구유가조작성，기중L4～5간극재해추궁근통도하적제수핵적가조작성최대。
Objective To describe the range of the upper intervertebral disc through the delfective pedicle channel and to explore the feasibility of discectomy through the channel.Methods Six adult spinal specimens were taken from cadavers and the pedicle channel reaching the upper intervertebral disc was made in 8 segments below the 10th thoracic vertebra. Image processing was performed for the range of the disc which was striken off. The ratio of the scraped area and the total area of the segment was calculated, and also the ratio of the scraped area and the total area of the front part and the rear part.Results The ratio of the scraped area and the total area was gradually increased from T10-11 to L4-5 and signiifcantly reduced in L5-S1, which was ( 16.96±0.54 ) %, ( 21.67±0.26 ) %, ( 21.52±1.13 ) %, ( 21.96±0.87 ) %, ( 22.64±1.04 ) %, ( 26.51±1.02 ) %, ( 33.87±1.32 ) % and ( 24.28±1.24 ) % respectively. The ratios of the scraped area and the total area of the front part and the rear part in T10-11 were ( 15.40±1.62 ) % and ( 24.57±0.60 ) %, which were ( 20.75±0.86 ) % and ( 23.96±1.18 ) %, ( 17.77±1.36 ) % and ( 24.33±1.08 ) %, ( 20.22±1.42 ) % and ( 25.06±1.22 ) %, ( 21.55±0.25 ) % and ( 22.26±0.85 ) % in T11-12, T12-L1, L1-2 and L2-3 respectively. The ratio of the rear part was greater than that of the front part from T10-11 to L2-3.Conclusions The discectomy from T10-11 to L4-5 can be performed through the delfective pedicle channel reaching the upper intervertebral disc, and the most satisfactory results can be found in the intervertebral space of L4-5.
