枢椎后路改良侧块螺钉钉道的CT测量  

Computered tomography morphometric analysis for the posterior improved lateral mass screw fixation on axis

作　　者：刘磊[1] 廖文波[1] 范红松[1] 孔维军[1] 覃建朴[1] 

机构地区：[1]遵义医学院附属医院脊柱外科,贵州遵义563099

出　　处：《遵义医学院学报》2017年第2期200-203,207,共5页Journal of Zunyi Medical University

基　　金：贵州省科技合作计划项目(NO:黔科合LH字[2015]7495)

摘　　要：目的通过对国人正常枢椎CT数据的研究,测量枢椎后路改良侧块螺钉的钉道长度以及进钉方向,为该螺钉的植入方法提供理论依据。方法对30例(其中男16例,女14例)正常成年人行颈椎CT平扫,收集扫描数据的DICOM格式,并用Mimics 15.0打开,以枢椎下关节突与椎板交界处下缘向上3 mm处为进钉点,向横突孔外侧缘进钉,测量该螺钉钉道的长度、外倾角及尾倾角。结果入选人群的平均年龄为(37.13±7.68)岁,钉道平均长度为(16.49±0.29)mm。外倾角平均角度为(13.10±0.20)°,尾倾角平均角度为(48.23±0.37)°。左右两侧及男女性对比差异均无统计学意义(P>0.05)。结论本研究表明枢椎后路改良侧块螺钉可应用于我国成年人,根据测量结果可指导该螺钉的植入,避免螺钉进入椎管及损伤横突孔等严重并发症,是枢椎椎弓根细小、椎动脉高拱合并椎板损伤时的另一种安全候补术式。Objective To evaluate the morphology of C2 posterior improved lateral mass screws for Chinese by measuring the length, and directions based on computered tomography （CT） data.Methods The cervical vertebrae of 30 patients were measured on CT scans.The CT scanning image data was input into the Mimics 15.0.Using an entry point 3-mm rostral to the junction of the C2 inferior aspect and lamina, the trajectory was direct toward the exterior border of the transverse foramen.The length and the angle of C2 improved lateral mass screw trajectory were evaluated.Results The mean patient age was （37.13 ± 7.68） years old.The average length of the screw trajectory was （16.49 ± 0.29）mm, 90% of which had a length above 15.99 mm.The mean lateral and downward inclination angle of the screw trajectory were （13.10 ± 0.20）° and （48.23 ± 0.37）°, respectively.There were no statistical differences between the left and the right sides, and among the sexes （P〉0.05）.Conclusion It is feasible to place C2 posterior improved lateral mass screws in Chinese patients.The results could guide the implantation of the screws and avoid the screws implanting into the spinal canal and the transverse foramen.It is a supplementary technique for the patients with a narrow pedicle, an enlarged high-riding VA and combining with injury of the lamina.

关 键 词：枢椎 侧块 内固定 CT扫描 

分 类 号：R687.3[医药卫生—骨科学]