摘要
目的研究下颈椎的相关解剖学特征,探讨颈前路反向椎弓根螺钉(ATPS)内固定技术的可行性。方法对30例下颈椎CT检查的影像学资料进行三维重建,利用Advantage Workstation4.2后处理工作站软件测量下颈椎的解剖学数据,进行统计学分析,制定出ATPS内固定的置钉参数。结果测量数据男性和女性、左侧和右侧比较,差异无统计学意义(P>0.05)。C3～C4进钉点位于置钉椎弓根对侧,正中矢状面旁2mm,距椎体上终板平面7～8mm,进钉角度为外倾47°～48°、下倾8°～23°;C5进钉点位于置钉椎弓根同侧,正中矢状面旁1～2mm,距椎体上终板平面7～8mm,进钉角度为外倾45°～48°、下倾9°～23°;C6～C7进钉点位于置钉椎弓根同侧,正中矢状面旁3～4mm,距椎体上终板平面7.5～8.5mm,进钉角度为外倾33°～40°、下倾10°～27°。C3～C7节段,进钉直径为3.5mm、4.0mm、4.5mm,进钉长度为30mm。结论 ATPS内固定技术可用于下颈椎内固定,并总结出进钉参数。ATPS内固定技术有可能对颈前路内固定翻修、椎体破坏、严重骨质疏松等困难情况提供帮助。
Objective To study the anatomical characteristics of lower cervical vertebrae and investigate the feasibility of cervical anterior transpedicular screw (ATPS) fixation.Methods Three-dimensional reconstruction of lower cervical vertebrae of 30 cases was performed according to the imaging data by CT examination.Using the Advantage Workstation (AW) 4.2 software,the anatomic data of lower cervical vertebrae in each group were measured for statistical analysis and the establishment of screw fixation parameters for ATPS fixation.Results Analysis of measurement data showed no statistically significant differences between males and females,as well as the left side and right side of the vertebrae (P > 0.05) .The entry point for C3 and C4 is in the opposite side of the pedicle with screw,2 mm from the median sagittal plane,7-8mm from the upper end plate,with the extraversion angle of 47°-48° and the declination angle of 8°-23°;the entry point for C5 is in the homonymy of the pedicle with screw,1-2 mm from the median sagittal plane,7-8 mm from the upper end plate,with the extraversion angle of 45°-48° and the declination angle of 9°-23°;the entry point for C6 and C7 is in the homonymy of the pedicle with screw,3-4 mm from the median sagittal plane,7.5-8.5 mm from the upper end plate,with the extraversion angle of 33°-40° and the declination angle of 10°-27°.From C3 to C7,the pedicle screw diameter is 3.5 mm,4.0 mm and 4.5 mm,and the screw length is 30 mm.Conclusion ATPS fixation technique can be used in lower cervical fixation,and its screw parameter was established.It may help to solve the problems such as anterior fixation rebuilding,vertebral destruction and severe osteoporosis.
出处
《徐州医学院学报》
CAS
2010年第8期520-523,共4页
Acta Academiae Medicinae Xuzhou
关键词
颈椎
椎弓根
解剖学
螺钉内固定
cervical vertebrae
pedicle
anatomy
screw fixation
