[24]CHARLES CY,YUH RT,BAJWA NS,et morphometry of lumbar vertebrae:male,taller,and heavier specimens have bigger ;40(21):1639-1646.

[25]MORALES AVALOS R,LEYVA VILLEGAS J,SáNCHEZ MEJORADA G,et gender-related variations in morphometric characteristics of thoracic spine pedicle:A Study of 4,800 ;27(3):441-450.

[26]MERLOZ P,TONETTI J,PITTET L,et screw placement using image guided Orthop Relat Res.1998;354:39-48.

[27]ALBANO J,LENTZ J,STOCKTON R,et Analysis of Lumbar Pedicle Diameters in a Diverse Spine J.2019;13(3):410.

[28]STOCKTON R,ALBANO J,LENTZ J,et al.A comparison of lumbar transverse pedicle angles between ethnic groups:a retrospective Musculoskelet ;20(1):114-121.

[29]TSE MSH,CHAN CH,WONG KK,et anatomy of C7 vertebra in Southern Chinese for insertion of lateral mass screws and pedicle Spine J.2016;10(4):705-710.

[30]TAN SH,TEO EC,CHUA three-dimensional anatomy of cervical,thoracic and lumbar vertebrae of Chinese Spine J.2004;13(2):137-146.

[31]CHADHA M,BALAIN B,MAINI L,et morphology of the lower thoracic,lumbar,and S1 vertebrae:an Indian ;28(8):744-749.

[32]ACHARYA S,DORJE T,SRIVASTAVA A.Lower dorsal and lumbar pedicle morphometry in Indian population:a study of four hundred fifty ;35(10):E378-E384.

[33]CHARLES CY,BAJWA NS,TOY JO,et morphometry of upper thoracic vertebrae:an anatomic study of 503 cadaveric ;39(20):E1201-E1209.

[34]MCLAIN RF,FERRARA L,KABINS morphometry in the upper thoracic spine:limits to safe screw placement in older ;27(22):2467-2471.

[35]PERDOMO-PANTOJA A,ISHIDA W,ZYGOURAKIS C,et of Current Techniques for Placement of Pedicle Screws in the Spine:A Comprehensive Systematic Review and Meta-Analysis of 51,161 ;23(2):1-15.

[36]KOBAYASHI K,ANDO K,ITO K,et radiation exposure in spinal scoliosis surgery for pediatric patients using the O-arm?imaging J Orthop Surg ;28(4):579-583.

[37]PITTELOUD N,GAMULIN A,BAREA C,et exposure using the O-arm?surgical imaging Spine J.2017;26(3):651-657.

[38]ZHU W,SUN W,XU L,et invasive scoliosis surgery assisted by O-arm navigation for Lenke Type 5C adolescent idiopathic scoliosis:a comparison with standard open approach spinal ;19(4):472-478.

[39]SIDDIQUI MI,WALLACE DJ,SALAZAR LM,et pedicle screw placement:learning curve Neurosurg,2019;107(6).E1-E6.

[40]CHUA M J,SIDDIQUI S,YU C S,et al.The optimal screw length of lumbar pedicle screws during minimally invasive surgery fixation:a computed tomography-guided evaluation of 771 Spine J.2019;76(2):1-6.

[41]LAI DM,SHIH YT,CHEN YH,et of pedicle screw diameter on screw fixation efficacy in human osteoporotic thoracic ;70(6):196-203.

[42]VARGHESE V,KUMAR GS,KRISHNAN V.Effect of various factors on pull out strength of pedicle screw in normal and osteoporotic cancellous bone Eng ;40(8):28-38.

[43]MATSUKAWA K,YATO Y,IMABAYASHI H,et evaluation of fixation strength among different sizes of pedicle screws using the cortical bone trajectory:what is the ideal screw size for optimal fixation?Acta ;158(3):465-471.

[44]HIRANO T,HASEGAWA K,TAKAHASHI H E,et Characteristics of the Pedicle and Its Role in Screw ;22(21):2504-2510.

[45]LI X,WANG X,GAO S,et tomography measurement of the bone matrix of vertebral pedicle and its clinical ;21(1):1-11.

[46]LIU K,ZHANG Q,LI X,et application of a multi-level 3D printing drill guide template for pedicle screw placement in severe and rigid Spine J.2017;26(8):1684-1689.

[47]SOLITRO GF,WHITLOCK K,AMIROUCHE F,et Adopted Criteria for Pedicle Screw Diameter J Spine ;13(4):132-145.

[48]HELGESON MD,KANG DG,HELGESON MD,et insertional torque allows prediction for better pedicle screw fixation and optimal screw size J.2013;13(8):957-965.

[49]STOCKTON R,ALBANO J,LENTZ J,et al.A comparison of lumbar transverse pedicle angles between ethnic groups:a retrospective Musculoskelet ;20(12):114-124.

[50]GARFIN SR,EISMONT FJ,BELL GR,et and Herkowitz’s the Spine 7th ;28(1):360-370.

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。

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