| Objective : Due to the influence of ilium wing, L5 screws implant process,this study intends to increase the difficulty of lumbar CT image data throughthe analysis of measuring, combining with vector analysis, 3d reconstruction,judging by the relevant research data of screw placement of ilium wing withmen and women the influence of ilium wing height, change degree and thepedicle of E Angle, F Angle of relationship. For L5 pedicle screws providerelevant anatomy fixation preoperative support parameters. And the L5 pediclescrews for surgery before judge the influence of ilium wing provide theoreticalbasis.Methods: the data of 56 cases with lumbar images belong to the FirstHospital of Jilin University video branch Philips 64-slice CT scanning cases.Eliminate cases: (1) obvious scoliosis, lumbar spinal deformity. (2) pregnancyor breastfeeding women; (3) minors under 18 patients; (4) the patients oftuberculosis, cancer and other forms of disease destroying bone. (5) thepatients with low ilium wing, CT scan L5 screws into the pedicle screw levelsand the ilium wing is not seen. Scanning into a thick layer of 1mm, scanninginterval 0.7 mm, including complete L1 vertebral body and all to S1 annexstructure, video images are quite distinct cases. The number of male patients is28 while that of female is 28.Through the First Hospital of Jilin UniversityGE4.3 workstation, the further three-dimensional CT examination of lumbar ismade to the patients, and the related parameters is measured. 1. E Angle and FAngle; 2. The shortest transverse diameter, longitudinal diameter in the centerof the plane; 3. Measuring the impact of ilium wing by relevant distanceparameters, i.e. d1 into nail point and iliac wing to the body the midline non-oil imports from distance；d2 into nails point and iliac wing to screw non-oilimports from the distance and axial extension；to the body the midline non-oilimports d3, divides and nail leads vertical shaft intersections to extension cordto the body the midline distance; 4. In the case of determining TSA, measuringpedicle screw length which deep in; 5. Through the determination of the two3mm center plane, measuring respective d2 of these two planes; 6. To L5pedicle axis, and determined by the point for optimal into nail line. Applicatingthe reformat program in the workstation to research and judge the pedicle screwpoint.Results:1. Male left horizontal diameter 13.13±2.17mm, female left horizontaldiameter 12.23±2.07mm; Male right horizontal diameter 12.85±2.46mm,female right horizontal diameter 11.96±1.88mm; Male left longitudinaldiameter 11.24±1.59mm, female left longitudinal diameter 9.59±1.66mm;Male right longitudinal diameter 11.41±1.33mm, female right longitudinaldiameter 9.23±1.33mm.2. Male left E Angle 28.85±5.60°, female left E Angle 29.91±6.75°;Male right E Angle 29.46±4.57°, female right E Angle 29.18±6.69°;3. Male left F Angle 2.68±0.90°, female left F Angle 3.18±0.98°;Male right F Angle 2.86±0.93°, female right F Angle 3.39±1.47°.4. Men and women bilateral screw length: male left 50.54±3.54mm,female left 49.28±3.51mm; Male right 51.22±3.44mm, female right49.50±3.59mm.5. Male left d1:60.91±8.61mm, female left d1:61.71±8.71mm; Maleright d1:64.04±9.58mm, female right d1:62.67±9.07mm.6. Male left d3:39.02±6.19mm, female left d3:34.46±5.79mm; Maleright d3:38.30±6.45mm, female right d3:34.76±5.63mm. Conclusion:(1) Ilium wing affects L5 PS implantation(2) The L5 pedicle screws implanted influence is mainly affected by theinfluence of ilium wing, and development of ilium wing in lumbar di ministrycurve, the change of the ilium wing altitude and iliac wing edge to laminadistance involved; And the effect of pedicle E Angle and pedicle of horizontaldiameter, longitudinal diameter is not obvious(3). Because male patients iliac wing to lamina distance is farther than thatof female. When implanting L5 PS, the effect of lumber ilium wing on pediclescrew is greater than that on female.(3) Found that men in medical statistics in 30 patients, including 28patients at the waist 5 pedicle into nail plane see iliac wing; Women 45 patients,28 patients at the L5 pedicle into nail plane see iliac wing. Speculation malevertebral height, slightly higher than the women affected more than womendegree.(4) To the same patient, the both sides of the vertebral pedicle E horn,F Angle is symmetrical on the whole, no big difference. To the same patient,the both sides of pedicle screws length, diameter no obvious difference.(5) Pedicle E angle, F angle do not exist gender differences.(6) The main factors that affect screws diameter are longitudinal diametersize, men are longitudinal diameter > women pedicle screw, so men's choice isslightly more than that of women. |
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