经s1骶髂螺钉参数测定及经皮螺钉导向器可行性 - 南方医科大学学报.pdfVIP

J South Med Univ, 2014, 34(6): 869-874 doi 10.3969/j.issn. 1673-4254.2014.06.23 ·869 · 临床研究 经经SS11骶髂螺钉参数测定及经皮螺钉导向器可行性的数字模型骶髂螺钉参数测定及经皮螺钉导向器可行性的数字模型 卢 超，宋迎春，高波华，王 钢 南方医科大学南方医院创伤骨科，广东 广州 510515 摘要：目的探讨一种新的第一骶椎（S1）骶髂螺钉定位方式，为导向器引导经皮骶髂螺钉固定的可行性提供应用解剖学基础。 方法 纳入100例正常成人骨盆CT 原始数据，重建骨盆三维模型。利用Mimics 软件中的相关功能寻找到以体表骨性标志定位 的S1骶髂螺钉理想操作平面，继而逐步测量该平面上的置钉参数，包括进针点、进针角度γ及安全范围，最后利用数字模型检验 新的置钉参数的准确性。结果 （1）髂前后上棘骨性突出点（分别为A、B）与S1椎体棘突中点构成的平面可作为操作平面；（2） AB 连线中后1/3 交点可作为此平面上的有效进针点；（3）男性角γ范围：101.4°~117.2° ，女性：109.5°~120.78° ，左右无差异，性别 间有差异；（4）按照新的参数置钉，80例半骨盆模型中置钉成功率统计：男性成功率：92.5% ，女性成功率：90%。结论 以A、B 和 S1椎体棘突中点定位操作平面，AB 连线中后1/3交点为进针点，男性采取角γ= 110° ，女性采取γ= 115°置钉满意，可作为新的螺钉 定位方式及进一步研发经皮导向器设计的应用解剖学依据。 关键词：骶髂关节；拉力螺钉；内固定术；应用解剖 Parameters of S1 screw fixation for percutaneous screw fixation of the sacroiliac joint using a targeting device: a digital model-based study LU Chao, SONG Yingchun, GAO Bohua, WANG Gang Department of Orthopedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China Abstract: Objective To explore a new approach to determining the location of S1 screw for percutaneous screw fixation of the sacroiliac joint using a targeting device. Methods Virtual three-dimensional pelvic models were reconstructed using the computed tomography (CT) scan data obtained from 100 adult subjects without any bony abnormalities. Mimics software was used to determine the ideal operating plane for S1 sacroiliac screw fixation based on the osseous marks. The parameters for screw fixation on the plane were measured, including the entry point, the needle angle (γ) and the safety range, and the accuracy of these parameters was verified using the digital models. Results The ideal operating plane could be determined by the osseous prominences of ASIS (A) and PSIS (B) and the midpoint of S1 vertebral spines. The point at t