儿童腰椎管及椎弓根形态特征的数字化与解剖学特征  

Digital and anatomical study about morphological characteristics of children's lumbar vertebral canal and pedicle

作　　者：王星[1,2] 史君[3] 张少杰[1,2] 李志军[1,2] 张元智[2] 刘红伟[1] 马世峰[1] 张志峰[4] 

机构地区：[1]内蒙古医科大学基础医学院解剖教研室,内蒙古自治区呼和浩特市010059 [2]内蒙古医科大学数字医学中心,内蒙古自治区呼和浩特市010059 [3]内蒙古医科大学基础医学院生理教研室,内蒙古自治区呼和浩特市010059 [4]内蒙古医科大学第二附属医院关节科,内蒙古自治区呼和浩特市010059

出　　处：《中国组织工程研究》2014年第13期2083-2088,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81260269);内蒙古自然科学基金(2012MS1149);内蒙古医科大学青年创新基金(YKD2013QNCX018)资助~~

摘　　要：背景:对于儿童脊柱损伤的外科治疗适应证及治疗方式等尚存在争议。目的:通过利用薄层CT影像资料并三维重建后测量,分析6-11周岁儿童腰椎椎弓根的形态、发育规律和增龄特征。方法:选取无脊柱外伤、畸形及神经症状的6-11周岁儿童60例,行多排螺旋CT薄层扫描(0.625-1.25 mm),范围为T12至S1,将原始数据以DICOM格式导入三维重建软件进行相关指标测量,并按不同节段进行统计分析。结果与结论:①椎管横径与矢径随年龄和椎序增加呈递增趋势。②椎弓根宽和高随年龄的增加呈递增趋势,椎弓根宽随椎序的增加呈递增趋势,而椎弓根高则随椎序的增加则呈缓慢递减趋势,椎弓根高大于椎弓根宽。③钉道长随年龄的增加呈递增趋势,在腰椎处整体呈"波浪"型,且各椎间无显著性差异。④e角随椎序的增加呈递增趋势,而f角则随椎序的增加则呈"波浪状"递减趋势。说明儿童腰椎椎管横径、矢径、椎弓根宽、高、钉道长、e角和f角与椎弓根螺钉置入有着密切的关系,临床应用中应根据儿童椎弓根的特征选取最佳的治疗方案。BACKGROUND：Indications and therapeutic method of surgical treatment for Children’s spinal injury are stil controversial. OBJECTIVE：To analyze the morphology, development regularities and age characteristics of lumbar pedicle of children aged 6 to 11 years old by using thin layer CT image data and three dimensional reconstruction. METHODS：A total of 60 children at the age of 6 to 11 years without spine trauma, deformity and neurological symptoms were selected, and were scanned with multi-row spiral CT （0.625-1.25 mm） from T 12 to S 1 . The original data were imported into three-dimensional reconstruction software by DICOM format, and related index was measured. The data were statistical y analyzed according to different segments. RESULTS AND CONCLUSION： ①With increasing age and vertebral levels, transverse diameter and radius vector of the spinal canal had an increasing trend. ②With the increase of age, the pedicle width and height had an increasing trend. With the increase of vertebral levels, the pedicle width had an increasing trend, but pedicle height had a slowly decreasing trend. The pedicle height was greater than pedicle width. ③With the increase of age, the nail path length had an increasing trend. In the lumbar vertebra, nail path presented“waves”on the＆nbsp;whole, and there was no significant difference between each vertebra. ④With the increase of vertebral levels, e angle had an increasing trend, but the f angle presented decreasing“wavy”trend. These results indicated that transverse diameter, radius vector, width and height of pedicle, nail path length, e angle and f angle were strongly associated with pedicle screw implantation. In clinical application, we should choose an optimal therapeutic method according to the features of pedicle of children.

关 键 词：植入物 数字化骨科 腰椎 椎弓根 形态特征 三维重建测量 儿童 解剖 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]