藏族与汉族成人腰椎椎弓根CT测量比较△

Comparison of CT measurements of lumbar pedicle between Tibetan and Han adults

摘要:

[目的]测量西藏藏族成年人腰椎椎弓根形态特点，同时对比藏汉两族及男女之间腰椎椎弓根形态差异，为西藏患者腰椎椎弓根螺钉固定提供可靠的解剖学数据。[方法]随机抽取本院符合纳入标准的测量对象，其中藏族 100 例，男 50 例， 女 50 例；汉族 100 例，男 50 例，女 50 例。通过 CT 检查测量 L₁~L₅椎体的椎弓根宽度、轴线长度、矢状径、横断面角和矢状面角，按民族、性别分组比较。[结果]200 例受测量者腰椎椎弓根宽度及横断面角度均由 L₁到 L₅逐渐增大(P＜0.05)，椎弓根矢状径由 L₁至 L₅均逐渐减小 (P＜0.05)，腰椎椎弓根的轴线长以 L3最大 (P＜0.05)，腰椎椎弓根矢状面角总体呈下降趋势 (P＜ 0.05)。藏族与汉族间腰椎椎弓根各径线的数据部分有差异，同种族间男性腰椎椎弓根宽度、轴线长、矢状径均显著大于女性(P＜ 0.05)。[结论]不同种族、不同性别间腰椎椎弓根形态测量存在差异，因此在行腰椎椎弓根内固定术时置钉角度与螺钉型号的选择应考虑种族及性别的差异，同时腰椎椎弓根形态存在个体差异，术前有必要对置钉椎体进行 CT 等检查。

Abstract:

[Objective] To search the morphological characteristics of lumbar pedicle in Tibetan adults by comparison of the morphologi- cal differences of lumbar pedicle between Tibetan and Han ethnic groups and between male and female to provide reliable anatomical data for lumbar pedicle screws fixation in Tibetan patients. [Methods] A total of 200 persons, including 100 Tibetan and 100 Han with 50 male and 50 female in each ethnic group were randomly selected based on the inclusion criteria. The pedicle width, axis length, sagittal diameter, cross-sectional angle and sagittal angle from L₁ to L₅ vertebrae were measured by CT examination, and compared between ethnic groups and gender groups. [Results] The lumbar pedicle width and cross-sectional angle increased from L₁ to L₅ in the 200 subjects (P＜0.05) , while the sagittal diameter of the pedicle decreased gradually from L₁ to L₅ (P＜0.05) , the axis length of lumbar pedicle was of the maximal value at L₃ levels (P＜0.05) , the lumbar pedicle sagittal angle was generally decreased up-down (P＜0.05) . The data in terms of some lumbar pedicle di- ameters were significantly different between Tibetan and Han ethnic groups, in addition, the male was significantly greater in terms of the width, axis length and sagittal diameter of lumbar than the female (P＜0.05) . [Conclusion] There are differences in the measurement of lum- bar pedicle morphology among different races and genders. Therefore, ethnic and gender differences should be considered in the selection of screw placement angle and screw type during lumbar pedicle internal fixation. In other words, it may be necessary to perform CT and other examinations on the involved vertebrae before operation.