Imaging measurement for internal fixation design of axial lumbosacral vertebral fusion viaposterior rectal space / 中国组织工程研究

ABSTRACT

BACKGROUND: The minimally invasive axial lumbar interbody approach (AxiaLIF) for L4–S1 fusion has been applied in America and Europe, and has obtained satisfactory curative efficacy. Because of significant anatomical differences between Chinese and Europeans and Americans, whether AxiaLIF is appropriate for Chinese remains unclear. Moreover,there are some problems in the application of AxiaLIF, so how to optimize AxiaLIF is a key to its promotion in China.OBJECTIVE: To provide anatomical data for the design of axial screws suitable for Chinese through measuring the mid axial line of the lateral lumbar radiograph and cross sections of L5 and S1 on lumbar CT in normal Chinese population.METHODS: The lateral lumbar radiographs from Chinese healthy population were selected, including 35 males and 30 females, the axial height of S1, the disc distance between L5 and S1, and the axial height of L5 were measured so as to provide anatomical data for designing the length of the axial screw. The transverse and sagittal diameters of L5 and S1 in the lumbar CT of 26 adult healthy males and 24 healthy females were measured to provide anatomical data for designing the diameter of the axial screw.RESULTS AND CONCLUSION: (1) The axial height of S1 in males and females was (26.76±3.94) mm and (22.91±2.91) mm, respectively (P 0.05). The axial height of L5 was (29.12±2.18) mm for males and (26.91±2.47) mm for females (P 0.05). (3) That is to say, this study provides the anatomical data for designing the axial screws suitable for the lumbar fusion of Chinese by measuring the mid axial line of the lateral lumbar radiographs and the cross sections of L5 and S1 on lumbar CT. The image measurement method can be used to analyze the preoperative images of the patients to predict the feasibility of the surgical approach and pre-select the internal fixation model for personalized screw positioning.