目的 在尸体标本上测量T1 ～T10胸椎经椎弓根-肋骨结构单元途径置入螺钉的安全角度及变化规律,为临床安全置入螺钉提供解剖学依据.方法 选取15例正常成人尸体标本,其中男9例,女6例,年龄18～60岁,平均40岁.将标本T1～T10胸椎分别沿椎弓根-肋骨平面横切,并测量T1 ～ T10各椎弓根-肋骨结构单元的横径、经椎弓根-肋骨结构单元途径置入的螺钉与矢状面的最小与最大安全成角及安全角度范围.结果 椎弓根-肋骨结构单元的横径变化规律为T1 ～T4逐渐变小,T5 ～ T10又逐渐变大；置钉安全角度范围为T1、T2最大,T5 ～T10次之,T3、T4最小；T1～T2及T5～ T10比较差异无统计学意义(P＞0.05),而T2～ T5比较差异均有统计学意义(P＜0.05),男性与女性比较无统计学意义(P＞0.05).结论 临床经椎弓根-肋骨结构单元置入螺钉时,应根据不同节段椎弓根-肋骨结构单元置钉安全角度的大小相应调整螺钉置入角度.%Objective To provide the anatomical basis for clinical safe screw placement by measuring the safe screw placement angle from T1 - T10 thoracic pedicle-frame structure unit way in adult body specimen. Methods 15 cases of normal adult body specimens, including 9 cases of male, and 6 cases of female, aged 18 ～ 60 years old, average age was 40. The T1 - T10 thoracic vertebras of the body specimen were transected along the pedicle of vertebral arch-frame plane, and we measured the transverse diameter of the T1 - T10 the pedicle of vertebral arch-frame structure unit, and the minimum and maximum safe angle between the sagittal plane and the screw placed from the pedicle of vertebral arch - frame structure unit way. Results The transverse diameter of pedicle of vertebral arch-frame structure unit decreased gradually from T1to T4, and increased gradually from T5 to T10. The range of safe screw placement angle was widest at T1 and T2, followed by T5 - T10, and was narrowest at T3 and T4. There was no significant difference in safe screw placement angle between T1-T2 and T5 - T10 (P > 0.05) , while there was a significant difference between T2 and T5 (P < 0.05). There was no significant difference in safe screw placement angle between the male and female (P > 0.05). Conclusion During placing screw from the pedicle of vertebral arch-frame structure unit, the screw placement angle should be adjusted according to the range of safe screw placement angle at different segmental pedicle of vertebral arch - frame structure unit.
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