寰枢椎关节畸形的影像学分类  

Radiological classification of atlantoaxial joint anomalies

作　　者：吴昕峰[1] 田伟[1] 王永庆[1] 马赛[1] 郑山[1] 张宁[1] 孙玉珍[1] 

机构地区：[1]北京积水潭医院,北京100035

出　　处：《山东医药》2010年第28期4-7,共4页Shandong Medical Journal

摘　　要：目的通过影像学分析在结构学上进行寰枢椎关节畸形的总结和分类,为不同手术方法的选择提供依据。方法对我院1 350个影像学资料完整的各种颈椎疾病病例进行重建CT图像分析并进行分类。结果共发现有35例寰枢椎关节畸形的病例。在矢状位畸形的26例病例中,我们分为5类畸形分别是前倾型侧块关节9例、后倾型侧块关节8例、双凸型侧块关节4例、融合型侧块关节2例和混合型侧块关节3例。另外我们还发现存在冠状位畸形5例(L型侧块关节2例、S型侧块关节1例和水平型侧块关节2例)、齿突前弓关节畸形3例和复杂型侧块关节1例,这些畸形可能和矢状位的畸形同时存在。结论寰枢椎关节存在诸多畸形,可能对手术方法的选择产生重大影响。临床上术前应常规进行冠状位和矢状位CT扫描,以明确手术方法的选择和安全性。Objective To analyze and classify the morphologic anomalies of atlantoaxial joints through radiology,which can provide evidences for the choice of operative technique.Methods Reconstructed CT views were obtained in 1 350 patients whose radiologic materials were intacted.These views were analyzed prospectively and classified.Results A total of 35 cases of morphologic anomalies of atlantoaxial joints were found.In 26 cases of sagittal anomalies,there are 5 kinds of anomalies： 9 cases of anteverted lateral mass joint,8 cases of retroverted lateral mass joint,4 cases of biconvex lateral mass joint,2 cases of fusional lateral mass joint and 3 cases of hybrid lateral mass joint.There are also 5 cases of coronal anomalies（2 cases of L-shaped lateral mass joint,1 case of S-shaped lateral mass joint and 2 cases of horizontal lateral mass joint）,3 cases of atlantodontal joint and 1 case of complex lateral mass joint.These anomalies may coexist.Conclusion The existing of deferent kinds of anomalies may significantly impact the operative technique.Coronal and sagittal CT reconstruction should be obtained as routine before operation in order to determine the choice of operative technique and to increase security of operative treatment.

关 键 词：寰椎 枢椎 畸形 分类法 

分 类 号：R682.1[医药卫生—骨科学]