摘要
背景:由于颈椎弓根较小的周径,高度的个体差异,周围复杂的解剖结构,在置椎弓根螺钉时易误伤脊髓、椎动脉及神经根,临床应用受到限制。正确的理解椎弓根及其周围结构解剖特点有助于提高经椎弓根螺钉内固定操作的安全性。目的:评价CT测量颈椎椎弓根在颈椎弓根内固定的临床意义。方法:随机选择81例正常成人颈椎CT片进行颈椎骨性指标的研究,测量指标包括13项:椎弓根高度、宽度,椎弓根内侧、外侧、上缘、下缘皮质厚度,椎弓根内松质骨高度、宽度,椎弓根轴线的骨性通道全长,椎弓根的长度1、长度2,椎弓根的内倾角和椎弓根轴线在矢状面上与椎体下终板之间的角度。结果与结论:椎弓根宽度小于高度,C3、C4外径最小,颈椎椎弓根的松质骨内径小,皮质骨比例高。外侧皮质骨较内侧和上、下侧皮质骨均薄。下颈椎椎弓根的三个通道长度变化不显著,内倾角和上下倾角则有一定区别。提示经螺旋CT可以较好的呈现椎弓根内部的情况,为颈椎弓根螺钉内固定提供影像学数据。
BACKGROUND： Because of small perimeter, different heights, complex anatomic structures of pedicle of cervical vertebra, the pedicular implantation may damage spinal cord, vertebral artery or nerve root. Correct understanding of pedicle and surrounding anatomic structures facilitate improvement of safety of transpedicular screw fixation. OBJECTIVE： To evaluate clinical significances of CT measurement of cervical vertebra pedicle in transpedicular screw fixation. METHODS： The cervical segments of 81 health adult vertebrae were measured by CT. The measured indexes included 13 items： pedicle height, pedicle width, lateral, internal, inferior and superior cortical thicknesses, spongy bone height and width, total pedicular length, pedicular length1, pedicular length2, pedicular transect angle and pedicular sagittal angle. RESULTS AND CONCLUSION： The pedicle width was smaller than corresponding height, and pedicle size was the smallest at C3 and C4 levels; the spongy bone diameter was small and cortical bone was high. The lateral cortical thickness was the thinnest among the internal, inferior and superior cortical thicknesses. The total pedicular length, the pedicular length1 and the pedicular length2 remained unchanged in C3 to C7, but there were some differences with the pedicular transect angel and the pedicular sagittal angle. CT can display internal morphology of lower cervical pedicle clearly and provide radiology data for transpedicular screw fixation.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第35期6532-6535,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
