摘要
目的:测量成人下颈椎椎弓根相关径线,为临床应用下颈椎椎弓根螺钉内固定提供相关解剖参数。方法:成人干燥尸体颈椎C3～C7标本20具,分别用手工和CT测量椎弓根宽度、高度,从横断面CT图像上测量椎弓根的内部宽度、内部高度,从纵断面CT图像上测量椎弓根矢状角。随机在CT室保存的100例成人患者的颈椎CT图像上测量椎弓根的宽度、自身长度和椎弓根通道全长、椎弓根内倾角。结果:下颈椎标本各节段椎弓根宽度、高度的手工测量值与CT测量值比较无统计学差异(P>0.05),椎弓根宽度小于高度;C3～C6节段CT测量椎弓根内部宽度平均为2.5～2.8mm,椎弓根内部高度平均为2.9～3.0mm,C7椎弓根的内部宽度和高度接近,约4.0mm;下颈椎标本CT测量椎弓根矢状角分别为C38.6°,C44.6°,C5-1.3°,C6-4.0°,C7-8.2°。100例成人下颈椎CT图像测量椎弓根宽度最小值为3.1mm(C3),最大值为9.3mm(C7),其中>3.5mm者为92.8%;椎弓根自身长度平均为19.1～20.5mm,椎弓根通道全长平均为33.2～35.0mm,椎弓根内倾角平均值C3～C5为43.2°～45.1°,C6为40.8°,C7为37.5°。结论:术前CT测量可为椎弓根准确置钉提供可靠的解剖参数,下颈椎椎弓根一般可接受直径3.5mm的螺钉固定。
Objective：To measure the dimensions of the lower cervical pedicle so as to provide anatomic data for clinical application of cervical pedicle screw fixation.Method：20 human adult cadaver cervical specimens containing C3 to C7 vertebrae were measured by two methods,one was manual measuring using digital caliper and the other was computed tomography scaning.Parameters measured manually included pedicle width （PW）,pedicle height （PH）.These specimens were scanned by CT scanner both perpendicular and parallel to the pedicle axis.The outer and inner pedicle width and height,cephalocaudad angulation of the pedicles in the sagittal plane were measured using automatic digital CT measurements. Additionally,cervical pedicle width and length,transverse angle （TA） of 100 patients＇ CT scans of C3-C7 cervical segment were measured.Result： There was no statistic difference between the data of pedicle width and height of 20 cadaver specimens obtained from manual and CT measurements individually.At C3-C6,the average internal pedicle width （IPW） ranged from 2.5 to 2.8mm,and the average internal pedicle height（IPH） ranged from 2.9 to 3.0mm.At CT,the IPW and IPH was approximately 4.0mm.The pedicle sagittal angel （SA） was 8.6° at C3,4.6° at C4,-1.3° at C5,-4.0° at C6,and -8.2° at C7 respectively.Based on the CT measurements of 100 patients,the data of the pedicle width varied from a minimum of 3.1mm for the C3 pedicle,to a maximum of 9.3ram for the C7 pedicle,and in 92.8% cases,the pedicle width was larger than 3.5mm.Pedicle length （PL） was about 19.1- 20.5mm,and total length（TL） of pedicle path was about 33.2-35.0ram.The pedicle TA was about 43.2°-45.1° at C3-C5,40.8° at C6,and 37.5° at C7 respectively.Conclusion：CT measurement can provide valuable data for cervical pedicle screw placement and lower cervical pedicle can hold screw with 3.5mm diameter.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2009年第7期535-539,共5页
Chinese Journal of Spine and Spinal Cord
关键词
颈椎
椎弓根
解剖学测量
影像学测量
Cervical spine
Cervical pedicle
Anatomic measurement
Radiographic measurement
