| 倪勇,胡伟,郭洪敏.基于CT多平面重建技术经Wiltse入路TLIF安全性分析[J].济宁医学院学报,2016,39(1):26-30 |
| 基于CT多平面重建技术经Wiltse入路TLIF安全性分析 |
| Operative safety study of transforaminal lumbar interbody fusion by Wiltse approach based on computer tomography multiplanar reformation |
| 投稿时间：2015-11-25 |
| DOI：10.3969/j.issn.1000-9760.2016.01.006 |
| 中文关键词: Wiltse入路;多平面重建;安全三角;椎间融合 |
| 英文关键词: Wiltse approach;Multiplanar reconstruction;Safety triangle;Intervertebral fusion |
| 基金项目: |
| 作者 | 单位 | | 倪勇 | 济南大学 山东省医学科学院医学与生命科学学院, 济南 250022 | | 胡伟 | 济宁医学院附属济宁市第一人民医院, 济宁 272011 | | 郭洪敏 | 济宁医学院附属济宁市第一人民医院, 济宁 272011 |
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| 中文摘要: |
| 目的 通过螺旋CT多平面重建技术(multiplanar reformation, MPR)测量腰神经根与毗邻结构解剖关系参数, 确定安全三角范围, 分析腰3至骶1(S1)节段wiltse入路经椎间孔腰椎体间融合术的安全性。方法 选取50名(男26名, 女24名)健康成人行腰椎CT检查, 年龄20~50岁之间, 无腰椎外伤及手术史, 无脊柱畸形、腰椎退行性变等疾病。通过Siemens Somatom Definition AS 128层CT行L3/4至L5/S1节段扫描, 多平面重建技术测量α角, AB线, 确定安全三角面积。结果 50名健康成人L3至S1节段通过CT MPR技术获得良好显像, α角 L4/5节段和L3/4节段大于L5/S1节段。AB线距离成逐渐增大趋势, 安全三角面积呈逐渐变大趋势。L3/4、L4/5、L5/S1节段右侧安全三角面积分别为:(100.40±30.56)mm2、(135.73±36.81) mm2、(142.99±44.93) mm2;左侧安全三角面积分别为:(103.27±31.69 )mm2、(138.53±34.63) mm2、(147.86±45.49) mm2;同节段α角、AB间距、安全三角面积男性均大于女性。同节段左右差异无统计学意义。结论 根据螺旋CT MPR技术及解剖学测量研究, 腰椎Wiltse入路TLIF在安全三角范围内操作具有较为重要的临床意义。 |
| 英文摘要: |
| Objective To measure the related anatomical parameters of lumbar nerve root and adjacent structures by computer tomography(CT) multiplanar reformation(MPR), determine the range of the safety triangle, and then analyze operative safety of transforaminal lumbar interbody fusion by Wiltse approach from L3 to S1 segment.Methods A total of 50 healthy volunteers, including 26 males and 24 females, who were 20 to 50 years old, underwent lumbar vertebrae CT scan.All the subjects were without spine deformity and lumbar vertebrae degeneration, who were also without lumbar vertebrae trauma and surgical history.The Siemens Somatom Definition AS 128 layer CT was used to detect L3/4-L5/S1 segments by imaging with Volume 3D Image post-processing software and MPR technique to measure the following anatomic parameters:α angle, AB line and the area of safety triangle.Results All the imaging of L3-S1 segments of the 50 healthy volunteers obtained through CT MPR technique was quite good.About the α angle, L4/5 and L3/4 segments was bigger than L5/S1 segment.From L3/4 to L5/S1, the AB line became longer and the safety triangle became bigger.The area of right safety triangle from L3/4 to L5/S1 were (100.40±30.56)mm2, (135.73±36.81) mm2 and (142.99±44.93) mm2 respectively.And the area of left safety triangle were (103.27±31.69) mm2, (138.53±34.63) mm2 and (147.86±45.49) mm2.Of the α angle, AB distance and the safety area of triangle at the same segment, male was bigger than female.There was no significant difference between the two sides of the same segment.Conclusion According to the anatomic measurement and calculation of spiral CT MPR technique, it is clinically important in TLIF by Wiltse approach for lumbar vertebrae that the operation being done within the safety triangle. |
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