颈椎单侧关节突交锁脱位的旋转角度及X线和CT表现的试验观测  

Study on the rotary angle,plain radiographs and CT appearance in unilateral locked facet of cervical spine

作　　者：何海潮[1,2] 赵宝林[2] 朱庆三[2] 马洪顺[3] 来颖[4] 刘景鑫[4] 吕中文[4] 

机构地区：[1]东阳市人民医院骨科,浙江东阳322100 [2]吉林大学中日联谊医院骨科,吉林长春130021 [3]吉林大学基础力学实验室 [4]吉林大学中日联谊医院卫生部放射生物重点实验室

出　　处：《中国骨伤》2010年第12期925-928,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:研究颈椎单侧关节突交锁的旋转角度及影像学特点,为早期诊断提供依据。方法:4具C1-T1段甲醛浸泡成人颈椎标本,2男2女,年龄28～40岁。试验前摄X线片和行CT扫描,用自制夹具分别固定C2-C4、C5-T1,并施加屈曲和旋转暴力,使标本分别在侧屈旋转、前屈旋转下模拟颈椎单侧关节突交锁,并部分模拟肌肉收缩,最后进行影像学分析。结果:颈椎单侧关节突交锁平均旋转角度为19.75°,椎体平均前方移位为3.68mm。以本试验摄片标准,0°、10°、180°、190°时损伤节段下位可见椎间孔;150°、160°、00°、-10°时损伤节段上位可见椎间孔,损伤节段关节突交锁或紊乱。交锁侧前斜位椎间孔变大,对侧前斜位椎间孔变小。CT平扫可见椎体旋转、关节突裸露征、关节突骨折等特点;冠状面三维重建可见双侧不对称;矢状面重建清晰可见关节突交锁。结论:X线和CT表现都可作为颈椎单侧关节突交锁的诊断依据,CT表现能更好地诊断单侧关节突交锁。Objective：To study the rotary angle and image features,so as to help early diagnosis.Methods：Four adult cervical spine（C1-T1） specimens were used,including 2 males and 2 females,ranging in age from 28 to 40 years old.X ray and CT examination were performed before the experiment.C2-C4 and C5-T1 were fixed respectively using self made clamp.Unilateral locked facet of cervical spine was simulated under the violence of inflection and rotation,in which the muscle contraction was partially simulated,and at last the plain radiographs and CT of unilateral locked facet of cervical spine were analyzed.Results：In unilateral locked facet of cervical spine,the average rotary angle was 19.75°,and average forward shift of vertebral was 3.68 mm.The intervertebral foramina below the injury plane were showed at 0°,10,°180°,190°;the intervertebral foramina above the injury plane were showed at 150°,160°,00°,-10°,and the facet was locked or in disorder at the injury plane.The intervertebral foramina at the anterior oblique position was bigger in interlocking side,but it was smaller in the opposite side.CT scan showed rotary spine,the naked facet sign;coronal plane reconstruction showed bilateral asymmetry;sagittal plane reconstruction obviously showed unilateral locked facet.Conclusion：X ray and CT both can independently diagnose unilateral locked facet of cervical spine.CT and three dimensional reconstruction are more better than X ray to diagnosing it.

关 键 词：颈椎 椎关节突关节 放射摄影术 体层摄影术 X线计算机 诊断 

分 类 号：R684.7[医药卫生—骨科学]