CT测量骶髂螺钉固定技术钉道参数安全范围分析.pdfVIP

18.25±3.06 ；最佳进钉点与椎弓根最狭窄处中心点距离（c1）：45.45±5.43mm；最佳 进钉点与椎体对侧前皮质距离(d1)：70.05±7.03mm ；最佳进钉点与髂后下棘距离 （f1）：22.10±4.55mm ；最佳进钉点与坐骨大切迹距离（g1）：17.94±3.54mm ；螺钉 与水平面夹角（i1）：14.41±1.74°；螺钉与冠状面夹角（j1)：13.36±2.74 °。 结论：1、S1螺钉的最佳进钉点位于由髂后上棘、髂后下棘连线为底边的等边三角形 的顶点上。S2螺钉的最佳进钉点位于S1进钉点与髂后下棘连线上。 2、S1最佳进钉方式为，钉尖指向S1椎体上部，进钉角度为与水平面成20.85 ±2.43°角，与冠状面成30.35±2.46°角。S2最佳进钉方式为，进钉的方向与水平 面成14.41±1.74°，与冠状面成13.36±2.74°夹角。 3、S1螺钉在保证有效固定强度下，选择单枚直径7.3mm、长度65mm螺钉固定较 为安全。S2螺钉在保证有效固定强度下，选择直径6mm、长度60mm螺钉较为安全。 4、单枚直径7.0mm的S1螺钉按标准术式操作时有向前后约4.88±1.06°，上下 约7.54±1.13°的可调整范围。螺钉长度、直径越大，可调整角度越小。 5、钉道参数有个体差异，术前CT能对患者特别是单侧骨盆后环的患者提供个性 化治疗计划，提高准确性。 关键词：骶髂螺钉，参数，最佳进钉方式，相对安全区域，CT。 3 万方数据 Study of safe range of the Parameters of Sacroiliac Joint Screw Path through CT Measurement Abstract Objective: To investigate the osseous channel for iliosacral screw insertion through three-dimensional computed tomography (3-D CT) reconstruction method to determine the parameters of sacroiliac joint screw path during the iliosacral screw fixation process . The study is to develop an appropriate method for screw insertion by investigating the relationship between bone landmark of the pelvic and the osseous channel for screw insertion. In addition, the study is to improve the safety of operation by the research on the relative safety area. Materials and Methods: Forty normal pelvic CT images were randomly selected among the images stored in the CT room of the First People’s Hospital of Chenzhou. All the images were stored in a dicom format. 3-D CT reconstruction was performed using ADW4.2 work station of GE Medical Systems. The parameters of the sacroiliac