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胸椎椎弓根-肋骨复合体的解剖及影像学研究

摘要

目的 探讨胸椎椎弓根-肋骨复合体的解剖结构影像学特点及其临床意义.方法 取4具成人新鲜尸体胸椎脊柱标本.主要测量参数(数据)包括:椎弓根及椎弓根-肋骨复合体的横径、螺钉最长值、矢状角,以及椎弓根、椎弓根-肋骨复合体以及椎弓根-肋骨重叠的纵径.测量中将尸体标本与CT影像测量(含二维、三维重建)相结合.结果 椎弓根-肋骨复合体是一立体结构,椎弓根与肋骨不在同一平面,且两者位置关系随不同节段而发生变化.椎弓根-肋骨复合体纵径值T1最小,为(12.6±0.8)mm,T11最大,为(16.9±1.1)mm.椎弓根-肋骨重叠纵径值T1最小,为(7.2±0.3)mm,T10最大,为(11.8±1.0)mm.椎弓根纵径与椎弓根-肋骨复合体纵径间差异无统计学意义(P>0.05),椎弓根纵径、椎弓根-肋骨复合体纵径均与椎弓根-肋骨重叠纵径间差异有统计学意义(P<0.05).结论 椎弓根-肋骨复合体是一较复杂的立体结构,椎弓根-肋骨重叠纵径应被视为该复合体的真实或有效纵径.%Objectives To investigate the spatial structure of pedicle rib units in normal thoracic human spines and to compare the dimensions of the pedicle rib unit with corresponding dimensions. Methods Thoracic spine specimens in four fresh adult cadaveric were used. Computerized tomographic (CT) images (including two-dimensional,three-dimensional reconstruction) of the thoracic spines were obtained. Measurement parameters include:the width, the height, the chord length and the sagittal angles of the pedicle rib unit compared with pedicle, especially for the pedicle-rib overlapping height. Results The pedicle rib unit was not a simple two-dimensional structure but a three-dimensional structure. The shortest height of pedicle rib unit was (12.6±0.8) mm (T1), while the longest was (16.9 ± 1.1) mm (T11 ). The shortest height of pedicle-rib overlap was (7. 2 ± 0. 3 ) mm (T1), while the longest was (11.8 ± 1.0) mm (T10). The height of pedicle rib unit and the height of pedicle were significantly larger than that of the pedicle-rib overlap( P <0. 05), while there was no significantly difference between the height of pedicle rib unit and the height of pedicle( P > 0. 05 ). Conclusions The pedicle rib unit is a complicated spatial structure, and the longitudinal height of pedicle-rib overlap should be taken as the real height of the unit.

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