【摘要】 目的 根据X线片和CT片测量胸腰段椎弓根及其相应结构的解剖参数，探讨总结一种椎弓根钉置入的改良方法。方法 此改良方法是由X线片和CT片测量获得椎弓根最大横径与小关节突旁的解剖标志确定椎弓根钉进钉点、长度、直径和方向，术中掌握e角、f角和手感。本组47例脊椎骨折并脊髓损伤病例，其中男45例，女2例；年龄19～49岁，平均38岁。共置入椎弓根钉206枚。结果 术后复查X线片和CT片，201枚钉置入椎弓根和椎体，3枚穿破椎弓根，2枚经椎弓根斜入椎间盘，失误率2.43%。但均无神经根和血管损伤。结论 本方法术前测量确定进钉点、长度、直径和方向，便于术中椎弓根钉的正确置入是一种较好的改良方法。

    【关键词】 胸腰椎； 椎弓根钉； 骨折固定

    Improvement on the fixed location of the nail pedicle in thoracolumbus

    PENG Hong,PENG Fang,LONG Zhong-lin.Trauma Center of the Affiliated Chinese and Western Medical Hospital,Chinese Medicine Research Institute,Hunan 410006,China

    【Abstract】 Objective To search a safer and a perfect method of locating of pedicle of vertebrarium treating thoracolumbar fractures and dislocation.Methods The position,length,diameter and direction of pedicle of vertebra was determinated according to the longest diameter of pedicle of vertebral and anatomy marker near small joint projecting measured by X-photograph and CT-photograph. And the e-angle,f-angle and hand feeling were kept control during the operated.Results 47cases aged19～49(45 males and 2 females) were operated.208 pedicles of vertebra were fixed into their bodies. The X-photograph and CT-photograph showed that 201 pedicles of vertebra were fixed into thoracolumbar and vertebral corpus,3ones crossed over thoracolumbar,2ones went inclined into intervertebral disk through thoracolumbar.The mistake rate was 2.43%.However,the injury of neural arch and the blood vessel were not found.Conclusion The control of the position,length,diameter and direction of pedicle of vertebra is more perfect method of locating of pedicle of vertebra. ......