摘要
目的:确定枢椎椎弓根的最狭窄部位并观察其内部结构特点,为临床应用提供解剖学参数。方法:32例经GE LightSpeed 16 Pro螺旋CT扫描的成人图像,扫描完成后行内插重建为层厚0.625mm、层距0.3mm,在ADW4.2软件上进行多平面重建处理。在椎弓根狭部复合体内倾中轴线做内倾纵向切面,于纵向切面上确定椎弓根上倾中轴线,沿该上倾中轴线做上倾斜向切面,在该上倾斜面上的最狭窄部作垂直切面即椎弓根的最狭窄部位。结果:如果不考虑上关节突皮质骨,典型椎弓狭部的皮质骨轮廓形状近似钩状,钩身为椎弓狭部的内侧壁,钩尖为椎弓狭部的外侧壁部分,髓腔形状多呈竖置的椭圆形,内侧壁厚度(2.4±0.53)mm明显大于外侧皮质骨厚度(1.2±0.76)mm,椎弓狭部上方骨皮质厚度(2.7±0.76)mm明显小于下方部骨皮质厚度(3.2±0.92)mm,P<0.01。结论:椎弓狭部中段的外侧皮质骨厚度呈菲薄样,经椎弓根狭部复合体螺钉的方向以偏内偏上的安全系数高;对于国人来讲,枢椎的椎弓根内固定螺钉直径多以3～3.5mm较为合适。
Objective： To identify anatomic features of the narrowest site of C2 pedicle and provide basic data for clinical application. Methods： The data of GE LightSpeed 16 Pro spinal CT scan from 32 cases were loaded into an imaging station （software ADW4.2）. Firstly, the mediolateral logitudial section was worked out along the pediculoisthmic axis. Secondly, the retrocaudal section was cut along the axis which was made in the mediolateral logitudial section. Lastly, the narrowest site of the pedicle was determined in retrocaudal section, after cutting this section vertically. The correlative parameters were measured and the data was analyzed statisticly with SAS 6.12 software. Results： The typical shape of the narrowest site looked like a fishhook except for cortical bone of the superior articular processs. The inner of cavity was oval. The medial isthmus cortical bone was significantly thicker than that of the lateral one, and the inferior isthmus cortical bone was significantly thicker than that of the superior one （P 〈0.01）. Conclusions： Considering the flimsy lateral isthmus cortical bone, the media-lateral direction of the pediculoisthmic screw is suggested during the operation. The screw of axial pedicle with the diameter of 3-3.5mm is suitable.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2009年第2期170-173,共4页
Chinese Journal of Clinical Anatomy
关键词
枢椎
椎弓根
狭部
CT重建
axis
pedicle
isthmus
CT reconstruction
