单侧入路经皮椎体后凸成形术关键参数的影像学测量

摘要

目的 探索基于影像学测量获得单侧入路经皮椎体后凸成形术的关键参数,为临床操作提供参考. 方法 随机选择我科住院患者的胸椎、腰椎CT片各120例,利用我院影像科PACS系统、Uniweb Server软件,通过模拟单侧入路经皮椎体后凸成形术的最佳穿刺路径,测出T4 ~L5 椎体穿刺路径的内倾角、尾倾角、皮肤入针点旁开棘突的距离. 并结合临床实践,验证数据的准确性. 结果 单侧穿刺途径:T4 ~T9 椎体,内倾角(24.6 ± 4.2)°,尾倾角(19.8 ±1.8)°,棘突旁开距离(3.5 ±0.5)cm. T10 ~L2 椎体,内倾角(25.6 ±4.8)°,尾倾角(18.5 ± 1.6)°,棘突旁开距离(3.8 ±0.6)cm. L3 ~L5 椎体,内倾角(34.2 ±7.8)°,尾倾角(17.5 ±1.9)°,棘突旁开距离(5.9 ±1.2) cm. 结论 基于影像学测量获得关键参数,是顺利进行单侧入路经皮椎体后凸成形术的重要依据,根据测量的数据指导临床实践,操作简便、安全,穿刺准确性高,对临床操作有一定的参考价值.%Objective To obtain the key parameters required for the unilateral transpedicular approach on percuta-neous kyphoplasty through imaging measurement, so as to provide evidence for clinical practice.Methods A total of 120 CT images of thoracic and lumbar vertebrae were randomly collected from patients in our department.Then, using the PACS system and Uniweb Server software, the angles of introvertion and declination, and the distance between the skin entry point and the spinous process from T4 to L5 were measured through imitation of percutaneous kyphoplasty via the u-nilateral transpedicular approach.Meanwhile, the accuracy of the measurement was verified on the basis of clinical prac-tice.Results The unilateral transpedicular puncture yielded an introvertion angle of (24.6 ±4.2) for T4 -T9 , (25.6 ±4.8) for T10 -L2 and (34.2 ±7.8) for L3 -L5 and a declination angle of (19.8 ±1.8) for T4 -T9, (18.5 ±1.6) for T10 -L2 and (17.5 ±1.9) for L3 -L5 .The distance between the skin entry point and the spinous process was (3.5 ±0.5) cm for T4 -T9 , (3.8 ±0.6) cm for T10 -L2 and (5.9 ±1.2) cm for L3 -L5 .Conclusion The key parame-ters obtained through radiographic measurement are of importance for percutaneous kyphoplasty via the unilateral transpe-dicular approach, making the operative procedures convenient, safe and accurate when applied in clinical practice.