贵州地区人群下颈椎后路经椎弓根置钉的相关解剖学观察  

Anatomical observation of human of pedicle screw insertion for low cervical spine in Guizhou Province

作　　者：王远政[1] 田晓滨[1] 刘洋[2] 李波[1] 孙立[1] 张一[1] 田家亮[1] 

机构地区：[1]贵州省人民医院骨科,贵阳550002 [2]重庆医科大学附属第二医院骨科

出　　处：《贵州医药》2012年第10期869-872,共4页Guizhou Medical Journal

基　　金：贵州省社会发展科技攻关项目(黔科合SY[2010]3115号)

摘　　要：目的通过对贵州地区大样本成人下颈椎椎弓根的解剖学观察,为后路经椎弓根置钉技术提供临床相关解剖学参数。方法在我院门诊对排除颈椎骨质破坏性疾病的本地区成人患者中,随机选取100例进行颈椎薄层CT扫描,收集图像原始数据导入Mimics软件行三维重建,并利用其软件功能在三维重建图像上测量经椎弓根置钉的相关解剖学参数,包括C3-7椎弓根最窄处的高度、宽度,椎弓根通道长度(轴线长度),椎弓根内倾角及头倾角。结果通过100例成人活体下颈椎CT图像重建测量结果,我们可以得出:下颈椎椎弓根最窄处的高度大于宽度,C3-7平均椎弓根高度为7.24～7.42mm,平均椎弓根宽度为4.94～7.11mm,平均椎弓根轴线长度为31.98～34.01mm,椎弓根外倾角平均值分别为C346.3°、C447.2°、C548.8°、C640.1°、C737.5°,椎弓根头倾角平均值分别为C311.2°、C46.8°、C5-1.8°、C6-6.9°、C7-10.8°。结论大样本下颈椎椎弓根螺钉置入相关参数CT测量对该术的临床运用具有一定的参考价值,但发现椎弓根形态个体差异大,术前必须制定个体化置钉参数。Objective To observe the large sample of adults cervical pedicle anatomy in Guizhou region so as to provide anatomical parameters for clinical application of posterior cervical pedicle screw fixation. Methods In the adult patients of our hospital who have been excluded bone destructive disease.100 cases of cervical thin-section CT were randomly selected.CT dates were imported to software Mimics to establish cervical three dimensional reconstruction images.Then the related parameters of cervical pedicle were measured using measurement tools of Mimics.These parameters including Outer Pedicle Hight（OPH）,Outer Pedicle Width（OPW）.Pedicle Axis Length（PLA）;transverse Pedicle Angle（tPA）;sagittal Pedicle Angle（sPA）. Results Based on the CT measurement of 100 patients,it could obtain that OPH greater than OPW in lower cervical spine.At C3-7,the average OPH ranged from 7.24 to 7.42 cm,and the average OPW ranged from 4.94 to 7.11cm,and the average PLA ranged from 31.98 to 34.01cm.The tPA was 46.3° at C3,47.2° at C4,48.8° at C5,40.1° at C6,37.5° at C7.The sPA was 11.2° at C3,6.8° at C4,-1.8° at C5,-6.9° at C6,-10.8° at C7. Conclusion The relevant parameters CT measurement of large sample in low cervical pedicle screw fixation has certain reference value for clinical but anatomic appearance of low cervical pedicle varied a lot,the individual screw placement parameters should be determined by CT preoperatively.

关 键 词：下颈椎 椎弓根螺钉 内固定 解 剖 

分 类 号：R602[医药卫生—外科学] R683.2[医药卫生—临床医学]