骶髂关节前路钢板螺钉固定术相关的解剖学研究-人体解剖与组织胚胎学专业论文.docxVIP

万方数据 万方数据 目 录 中文摘要·······································································1 英文摘要················································································3 研究论文 骶髂关节前路钢板螺钉固定术相关的解剖学研究 前言·················································································5 材料与方法·····································································6 结果·················································································9 附图·······································································11 附表··············································································14 讨论·············································································15 结论··············································································20 参考文献·········································································21 综述 骶 髂 关 节 脱 位 骨 折 内 固 定 治 疗 进 展 及 生 物 力 学 分 析 · · · · · · · 2 3 致谢············································································33 个人简历··········································································34 中 中 文 摘 要 PAGE 10万方数据 PAGE 10 万方数据 骶髂关节前路钢板螺钉固定术相关的解剖学研究 摘 要 目的：通过对骶髂关节周围应用解剖和影像学解剖进行研究和分析， 明确骶髂关节损伤前路钢板螺钉系统固定的安全区域，为临床提供解剖依 据，并验证该固定方法的安全性和可行性。 方法：选择 10 具成人尸体骨盆作为研究对象，对其进行下列几个方 面的测量：1、对 L4、L5 神经前支到骶髂关节线的水平距离和到骶骨翼的 垂直距离进行测量；2、对从椎间孔到真骨盆缘的 L4、L5 神经根的长度及 其中点直径进行测量；3、在 CT 冠状位二维重建中对骶髂关节骶骨侧宽 度进行测量；4、在 CT 冠状位二维重建中对骶髂关节矢状面与切线的夹 角进行测量；5、选择 4 例 TileC 型骨盆骨折的患者作为研究对象，行骶 髂关节损伤前路双钢板固定治疗，同时根据患者骨盆前环损伤的不同情况 选择不同方法对其固定。进行术后定期随访，观察有无骶髂关节疼痛和局 部叩痛，有无 L4、L5 神经根损伤，以及双下肢长度的改变。 结果：从上到下 L4、L5 神经根与骶髂关节线的距离呈现出逐渐减小 的趋势，L4 神经根与骶髂关节线最宽的距离为（2.1±0.2）cm，L5 神经根 与骶髂关节线最宽的距离为（2.6±0.2）cm，L4 神经根与骶髂关节线最窄 的距离为（1.2±0.2）cm，L5 神经根与骶髂关节线最窄的距离为（1.5±0.2） cm；L4 神经根距离骶骨面具有从上到下逐渐减少的垂直距离，其最高的 部位大约具有 10mm 的距离，其最低的部位则与骨膜紧贴，全部的 L5 神 经根前支与骨膜紧贴；L4 神经根从出椎间孔到真骨盆边缘具有（7.4±0.8） cm 的长度，L4 神经根具有（2.7±0.8）mm 的中点直径；L5 神经根具有（3.9 ±0.5）cm 的长度，L5 神经根中点直径具有（7.3±1.4）mm 的长度；CT 重建中观察结果显示如下：骶髂关节矢状面与关节面具有大约 30 度的角 度；骶髂关节线具有从上到下逐渐减少的到椎管外侧缘的距离，