摘要
【目的】为下颈椎经椎弓根螺钉内固定提供应用解剖学基础及形态学资料。方法应用游标卡尺和量角器对24具成人颈椎干燥标本C3～7椎弓根的高度、宽度、骨性椎管长度、轴线长度、内外侧皮质厚度及轴线夹角进行解剖学测量，并分别计算各节段左右侧椎弓根测量值的均值和标准差，进行统计学分析。结果C3～7椎弓根的椎弓根最窄处截面上下皮质骨高度（PH）和松质骨高度（PSH）分别为4．21mm和7．64mm，宽度分别为3．64mm和5．88mm；轴线长度、骨性椎管长度及侧块部长度分别为15．75mm、32．20mm及8．12mm；最狭窄处内、外侧皮质厚度为0．68mm和1．65mm；椎弓根轴线与矢状线在水平面上的夹角C3：47．12°±3．05°、C4：43．47°±1．49°、C5：40．15±2．58°、C6：38．55°±2．45°、C7：35．16°±2．10°；椎弓根轴线与水平面间夹角C3：8．50°±2．50°、C4：4．83°±1．65°、C5：1．25°±1．45°、C6：-（4．50°±2．50°）、C7：-（8．50°±2．50°）。结论本实验实体测量数据与国内外数据无显著差异，但发现颈椎椎弓根解剖形态个体变异程度较大，术前必须对置钉椎体进行CT、X线片检查，确定适合个体的进钉点、进钉方向、螺钉直径及长度等。颈椎椎弓根螺钉技术仍然是一种相对安全、固定可靠的手术方法。
Objective To provide an anatomic basis and data about morphometry for the use of Transpedicular Screw fixation for the lower cervical spine. Methods The three-dimensional quantitative anatomy of Lower Cervical pedicle was determined in 24 adult cervical dry specimens using vernier caliber and conimeter. The parameters included the height, the width, the length, the axis angulation of the pedical. Average value and standard difference of the parameter in each level of the pedicles were calculated. Results The average value of height, width, length and thickness among the pedicles of C3-7 were 4.21 mm, 7.64 mm, 3.64 mm, 5.88 mm, 32.20 mm, 15.75 mm, 8.12 mm, 0.65 mm and 1.72 mm respectively. The angle of the axis in the sagittal plane was 47.12°±3.05° of C3, 43.47°±1.49° of C4, 40.15°±2.58°of C5, 38.55°±2.45°of C6, 35.16°±2.10° of C7. The angle of the axis in the horizontal plane was 8.50°±2.50° of C3, 4.83°±1.65° of C4, 1.25°±1.45° of C5, -（4.50°±2.500） of C6, -（8.50°±2.50°） of C7. Conclusion Various entities diagraph data had no significant difference between domestic and foreign dates, indicidual anatomic appearance of lower cervical pedicle varied a lot. The individual point and direction of penetration, diameter and length of screw should be determined by X-ray film and CT preoperatively. The technique of lower cervical transpedicle screw is still relativity safety and reliable.
出处
《脊柱外科杂志》
2006年第6期354-358,共5页
Journal of Spinal Surgery
关键词
颈椎
内固定器
解剖学
cervical vertebrae
internal fixators
anatomy
