7-12岁儿童颈椎关节突关节的数字化三维形态研究  

Digital three-dimensional morphology of cervical joint facet in 7-12-year-old children

作　　者：刘路 王星 康小燕 李贵花 李筱贺 高尚 蔡永强 张少杰 李志军 Liu Lu;Wang Xing;Kang Xiaoyan;Li Guihua;Li Xiaohe;Gao Shang;Cai Yongqiang;Zhang Shaojie;Li Zhijun(Department of Anatomy,Inner Mongolia Medical University,Hohhot 010059,Inner Mongolia Autonomous Region,China;Digital Medicine Center,School of Basic Medicine,Inner Mongolia Medical University,Hohhot 010059,Inner Mongolia Autonomous Region,China;Department of Anesthesiology,Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine,Hohhot 010059,Inner Mongolia Autonomous Region,China;Department of Radiography,Inner Mongolia Autonomous Prison Administration Hospital,Hohhot 010059,Inner Mongolia Autonomous Region,China)

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]内蒙古医科大学基础医学院数字医学中心,内蒙古自治区呼和浩特市010059 [3]内蒙古自治区中医医院麻醉科,内蒙古自治区呼和浩特市010059 [4]内蒙古自治监狱管理局医院影像科,内蒙古自治区呼和浩特市010059

出　　处：《中国组织工程研究》2020年第6期877-881,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81260269,81560348,81860383)，项目负责人：李志军;国家自然科学基金(81660358)，项目负责人：张少杰;国家自然科学基金(81860382)，项目负责人：王星;内蒙古医科大学青年创新基金项目(YKD2017QNCX013)，项目负责人：刘路;内蒙古医科大学科技百万项目(2015YKDKJBW03)，项目负责人：张少杰;内蒙古医科大学科技百万项目(YKD2017KJBW009)，项目负责人：王星~~

摘　　要：背景:国内外学者研究均证实关节突关节面的不对称性和关节突关节角的不对称性均可导致关节退变、关节滑脱及相应的病变,但目前的研究均集中于成人。已证实随着年龄的增长,关节突关节的病变如小关节紊乱、绞锁等均是引起颈椎疼痛、失稳、滑脱、骨性关节炎及神经、血管受压甚至致瘫等的最常见原因之一。对于儿童关节突关节的相关研究则甚少。目的:通过收集7-12岁儿童颈椎CT影像扫描数据,行三维重建并行颈椎关节突关节的形态测量与分析,以探索关节突关节形态发育特征及增龄变化规律,为临床儿童颈椎病的早期诊断与治疗提供理论依据。方法:收集2013年9月至2015年9月间在内蒙古医科大学第一、二附属医院及内蒙古国际蒙医医院影像科行儿童颈椎多层螺旋CT扫描的影像资料99例,将原始以DICOM格式数据导入Mimics软件进行三维重建,并在三维模型上行形态学测量。试验于2015-03-11经内蒙古医科大学医学伦理委员会批准,批准号YKD2015049。结果与结论:①儿童颈椎关节突关节面长总体随年龄的增长呈递增趋势,随椎序的增长呈递减趋势;②关节突关节面宽中上关节突关节面宽呈V型,下关节突关节面宽随椎序递增呈增大趋势;③关节突关节结间距总体呈"尖峰"状;④关节突关节冠状位角整体呈"V"型;⑤关节突关节矢状位角呈倒"V"趋势;⑥提示7-12岁儿童颈椎节段关节突关节的形态学特征不存在关节突的不对称性。BACKGROUND: Lots of researches by domestic and foreign scholars have confirmed that the asymmetry of facet joint surface or the articular angles might cause the degeneration of the facet joints, and the articular spondylolisthesis. But most of the studies focus on the adult. It has been confirmed that the most common cause of the cervical disease, of the osteoarthritis, of the neurovascular compression or even the paralysis is the pathological changes of facet joint for people as they grow older. There are few studies on the facet joints in children. OBJECTIVE: To explore the cervical joint facet morphology development characteristics and age-related changes by collecting the CT scanning data of cervical vertebrae in children aged 7-12 years old, three-dimensional reconstruction and cervical facet joint morphology measurement and analysis. METHODS: Through collecting the data of multi-layers spiral CT scan of children in the First Affiliated Hospital and Second Affiliated Hospital of Inner Mongolia Medical University and Inner Mongolia International Mongolian Hospital from September 2013 to September 2015, 99 cases of cervical structures were selected. Then DICOM format of original data were imported in Mimics software for three-dimensional reconstruction. Morphological measurement was conducted on the three-dimensional model. The study was approved by the Ethical Committee of Inner Mongolia Medical University on March 11, 2015, approval No. YKD2015049. RESULTS AND CONCLUSION:(1) The length of children cervical joint facet was on a rise with age and a decreasing trend with ordinal number of vertebrae.(2) The width of children middle upper cervical joint facet showed "V" type. The width of children lower cervical joint facet increased with the increase of vertebral order.(3) The trend of distance between articular tubercles was "spike" shape.(4) The coronal angle of joint facet presented to be "V" shape.(5) The sagittal angle of joint facet was in inverted "V" shape.(6) In summary, there is no asymmetry of articul

关 键 词：颈椎 关节突关节 形态学特征 关节突关节角 儿童 

分 类 号：R459.3[医药卫生—治疗学] R681.5[医药卫生—临床医学]