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《The Journal of Traditional Chinese Orthopedics and Traumatology》 2016-01
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A feasibility study of upper thoracic vertebral plate screw fixation through posterior approach

ZHONG Xiqiang;HE Shaoqi;DONG Yilong;LIU Liangle;HUANG Yijiang;DAI Minghai;TANG Chengxuan;The Third Affiliated Hospital of Wenzhou Medical University;  
Objective: To study the anatomical parameters of upper thoracic vertebral plate of Chinese adults and explore the feasibility of upper thoracic vertebral plate screw fixation through posterior approach in Chinese adults. Methods: The cadaveric T1- 4 specimens of40 Chinese adults were selected and the anatomical parameters that related to the upper thoracic vertebral plate screw fixation technique were measured by using vernier caliper and conimeter. The anatomical parameters included the thickness of upper,middle and lower part of vertebral plate,the height of vertebral plate,the screw path length and the included angle between vertebral plate axis and sagittal plane.Results: There was no statistical difference in the thickness of the middle part of T4 vertebral plate and the included angle between T1- 4vertebral plate axis and sagittal plane axis between 20 females and 20 males( 5. 94 + /- 0. 13 vs 6. 00 + /- 0. 22 mm,t = 1. 609,P = 0. 112;46. 00 + /- 1. 10 vs 46. 50 + /- 1. 10 degrees,t = 1. 955,P = 0. 054; 46. 30 + /- 0. 80 vs 46. 60 + /- 1. 10 degrees,t = 1. 383,P = 0. 171;45. 40 + /- 1. 40 vs 45. 30 + /- 1. 40 degrees,t = 0. 404,P = 0. 688; 45. 20 + /- 1. 40 vs 45. 30 + /- 1. 40 degrees,t = 0. 410,P = 0. 683). The thickness of the middle part of T1- 3 vertebral plate were less in adult female cadavers compared to adult male cadavers( 5. 86 + /- 0. 10 vs5. 93 + /- 0. 18 mm,t = 2. 083,P = 0. 040; 5. 88 + /- 0. 11 vs 5. 97 + /- 0. 20 mm,t = 2. 581,P = 0. 012; 5. 90 + /- 0. 09 vs 6. 00 + /-0. 19 mm,t = 2. 885,P = 0. 006). Such parameters of T1- 4 were less in adult female cadavers compared to adult female cadavers as thickness of upper part of vertebral plate( 5. 39 + /- 0. 12 vs 5. 51 + /- 0. 13 mm,t = 4. 202,P = 0. 000; 5. 43 + /- 0. 09 vs 5. 52 + /- 0. 11 mm,t =4. 184,P = 0. 000; 5. 43 + /- 0. 10 vs 5. 53 + /- 0. 10 mm,t = 4. 279,P = 0. 000; 5. 41 + /- 0. 08 vs 5. 53 + /- 0. 07 mm,t = 7. 557,P =0. 000),thickness of lower part of vertebral plate( 5. 43 + /- 0. 12 vs 5. 55 + /- 0. 12 mm,t = 4. 513,P = 0. 000; 5. 43 + /- 0. 07 vs 5. 57 + /-0. 10 mm,t = 7. 068,P = 0. 000; 5. 44 + /- 0. 08 vs 5. 57 + /- 0. 11 mm,t = 6. 182,P = 0. 000; 5. 44 + /- 0. 07 vs 5. 58 + /- 0. 09 mm,t =7. 353,P = 0. 000),height of vertebral plate( 16. 86 + /- 0. 50 vs 18. 64 + /- 0. 71 mm,t = 13. 028,P = 0. 000; 16. 89 + /- 0. 62 vs19. 22 + /- 0. 76 mm,t = 15. 150,P = 0. 000; 17. 22 + /- 0. 52 vs 20. 09 + /- 0. 92 mm,t = 17. 179,P = 0. 000; 17. 45 + /- 0. 59 vs21. 10 + /- 0. 95 mm,t = 14. 976,P = 0. 000) and screw path length( 29. 23 + /- 1. 24 vs 31. 43 + /- 2. 01 mm,t = 5. 898,P = 0. 000;29. 77 + /- 1. 48 vs 31. 29 + /- 2. 44 mm,t = 3. 358,P = 0. 000; 29. 58 + /- 1. 50 vs 30. 68 + /- 2. 25 mm,t = 2. 590,P = 0. 000; 29. 94 + /-1. 48 vs 30. 69 + /- 2. 05 mm,t = 1. 873,P = 0. 000). Conclusion: It is feasible to conduct the upper thoracic vertebral plate screw fixation in Chinese adults through posterior approach in the view of anatomy,so this method can be used as a complement to the lower cervical vertebra fixation technique through posterior approach.
【Fund】: 浙江省瑞安市科学技术局社会发展科学研究项目(201102051)
【CateGory Index】: R687.3
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