背景：关于成人胸腰段椎弓根形态的研究已经发表了大量文献，但对青少年椎弓根形态的了解较少，尤其是在亚洲人群中。青少年脊柱疾患日益增多且精确的形态学研究较少。

目的：研究内蒙古地区12-15岁青少年腰椎的解剖结构，为椎弓根螺钉置入提供详细资料，确定安全合适的螺钉大小，并为螺钉尺寸设计提供数据参考。

方法：收集内蒙古地区65例12-15岁青少年正常胸腰CT 资料，根据年龄分2 组，12-13岁31例，14-15岁34例。将连续扫描的胸腰椎断层影像原始数据以DICOM 格式导入Mimics 21.0分析与测量，指标包括椎弓根宽、椎弓根高、椎管横径、椎管纵径、椎弓根长、椎弓根外偏角、椎弓根最大外偏角、椎弓根头倾角及椎弓根面积。

结果与结论：①2 组L1-L4椎弓根宽小于椎弓根高，L5椎弓根宽与椎弓根高相似，椎弓根宽决定螺钉直径，男性大于女性；②12-13岁，螺钉长L1-L5均为40-45 mm；14-15岁，螺钉长L1-L4为40-45 mm，L5为45-50 mm；③2 组规律相同，椎管横径均大于椎管纵径，椎管横径、椎管纵径之间差异有显著性意义(P＜0.05)，男女之间差异无显著性意义；④椎弓根外偏角：12-13岁L1-L2变化不大，L2-L5逐渐增大；14-15岁L1-L5逐渐增大，2 组均男性大于女性；⑤椎弓根最大外偏角：2 组规律相同，L1-L5逐渐增大，随年龄增长而减小，左右侧与性别间差异均无显著性意义，不同年龄间差异有显著性意义(P＜0.05)；⑥椎弓根头倾角：12-13岁为3°-8°，14-15岁为0°-5°；随年龄增长而减小，L3-L4男女之间差异有显著性意义(P＜0.05)；⑦椎弓根面积：2 组规律相同，L1-L5逐渐增大，L4-L5有一个明显的变化趋势；⑧根据椎弓根参数分析可得出正常青少年腰椎各节段置入螺钉的适合尺寸，帮助临床医师掌握腰椎解剖结构，提高置钉准确性。

国家自然科学基金()，项目负责人：李筱贺；国家自然科学基金(，)，项目负责人：李志军；内蒙古教育厅青年科技英才项目(njyt-15-b05)，项目负责人：李筱贺；内蒙自治区科技计划项目(2016)，项目负责人：李筱贺；内蒙古自治区科技创新引导项目(2017)，项目负责人：李筱贺；内蒙古自治区自然科学基金(2016ms08131)；内蒙古人社厅归国留学人员基金(TKD2017KJBW012)，项目负责人：李筱贺；内蒙古医科大学科技百万计划基金项目(YKD2017KJBW012)，项目负责人：王海燕

BACKGROUND:A large amount of literature has been published on the vertebral pedicle morphology at thoracolumbar segments in adults,but little is known about the morphology of pedicles in adolescents,especially in Asian spine disorders are increasing and there are few precise morphological studies.

OBJECTIVE:To investigate the anatomy of lumbar vertebrae of adolescents aged 12-15 years in Inner Mongolia,provide detailed information for pedicle screw placement,determine the safe and appropriate screw size,and provide data reference for screw size design.

METHODS:The normal chest and lumbar CT data of 65 adolescents aged 12-15 years in Inner Mongolia were collected and divided into two groups,31 cases of 12-13 years old,and 34 cases of 14-15 years old.The raw data of the thoracic and lumbar vertebrae images scanned continuously were imported into Mimics 21.0 for analysis and measurement in DICOM width,pedicle height,transverse diameter,longitudinal diameter,pedicle length,pedicle outer declination,pedicle maximum external angle,pedicle head inclination,and pedicle area were measured.

RESULTS AND CONCLUSION:(1)The L1-L4pedicle width in the two groups was less than pedicle height,and pedicle width and pedicle height at L5were pedicle width determined the screw diameter,which was larger in males than in females.(2)In 12-13 years old,the screw length at L1-L5was between 40-45 mm.In 14-15 years old,the screw length was between 40-45 mm at L1-L4,and 45-50 mm at L5.(3)The laws of the two groups were the same.The transverse diameter of spinal canal was significantly larger than longitudinal diameter of spinal canal(P＜0.05),and there was no significant difference between men and women.(4)The transverse pedicle angle:In 12-13 years old,L1-L2had small change,L2-L5gradually increased;in 14-15 years old,L1-L5gradually increased;it is larger in males than in females in both groups.(5)Maximum transverse pedicle angle:The two groups had the same increased,and decreased with was no significant difference between left and right sides and was significant difference among different ages(P＜0.05).(6)The sagittal pedicle angle:The in 12-13 years old,3°-8°;in 14-15 years old,0°-5°.The value decreased with age,and there was significant difference between men and women in L3-L4(P＜0.05).(7)Pedicle area:The two groups had the same increased,and L4-L5had a clear trend of change.(8)Analysis of pedicle parameters showed that the size of the screws in the lumbar vertebrae of normal adolescents was suitable for the clinician to grasp the anatomy of the lumbar spine and improve the accuracy of clinical operation.

文章来源：《青少年体育》 网址: http://www.qsntyzz.cn/qikandaodu/2020/0718/426.html