建立计算机模型探索颅底凹陷导致寰枢椎脱位的力学机制的研究  

Research on Building Computer Model to Explore the Mechanical Mechanism of Atlantoaxial Dislocation Caused by Basilar Invagination

作　　者：郎大卫 薄雪峰 LANG Dawei;BO Xuefeng(School of Biomedical Engineering,Capital Medical University(Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application),Beijing 100069,China)

机构地区：[1]首都医科大学生物医学工程学院(临床生物力学应用基础研究北京市重点实验室),北京100069

出　　处：《中国医疗设备》2021年第3期44-48,共5页China Medical Devices

基　　金：北京市自然科学基金(7172091)。

摘　　要：目的建立计算机模型,测量并分析颅底凹陷程度、寰枢椎脱位程度、侧方关节畸形程度和齿状突畸形程度之间形态学参数的相关性,为研究齿状突、侧方关节畸形引发寰枢椎脱位的生物力学机制提供形态学依据。方法收集60位志愿者颈椎断层CT扫描序列图像数据并分为正常对照组、颅底凹陷不伴有寰枢椎脱位组、颅底凹陷伴有寰枢椎脱位组,每组各20例。利用Mimics Research 20.0软件建立三维模型,测量形态学参数并利用IBM SPSS 21软件进行统计学分析。结果齿状突尖部到Chamberlain线距离、ADI、齿状突高度、齿状突高度/基底宽度、齿状突倾角1和2、矢状位关节倾角、颅颈倾角整体差异有统计学意义(P<0.05)。齿状突高度/基底宽度与矢状位关节倾角显著负相关(r=-0.687,P<0.001),齿状突高度和齿状突高度/基底宽度与颅底凹陷和寰枢椎脱位显著负相关(r=-0.573,P<0.001)。矢状位关节倾角与颅底凹陷和寰枢椎脱位显著正相关(r=0.691,P<0.001),颅颈倾角仅与颅底凹陷显著正相关(r=0.644,P<0.001)。结论齿状突畸形、侧方关节畸形是颅底凹陷患者出现寰枢椎脱位的重要原因。Objective To build a computer model,measure and analyze the correlation of morphological parameters among the degree of basilar invagination,atlantoaxial dislocation,lateral joint deformity and odontoaxial deformity,so as to provide morphological basis for studying the biomechanical mechanism of atlantoaxial dislocation caused by odontoid process and lateral joint deformity.Methods Cervical CT scan data of 60 volunteers were collected and divided into normal control group,patients with basilar depression without atlantoaxial dislocation group,and patients with basilar depression combined with atlantoaxial dislocation group,20 cases in each group.Mimics Research 20.0 software was used to establish three-dimensional models.A series of morphological parameters were measured and analyzed using IBM SPSS 21 software.Results There were statistically significant differences in the distance from the tip of dentate process to the Chamberlain line,ADI,height of dentate process,height of dentate process/base width,inclination Angle of dentate process 1 and 2,sagittal joint inclination Angle and craniocervical inclination Angle(P<0.05).The height/base width of dentate process was negatively correlated with sagittal joint inclination angle(r=-0.687,P<0.001),while the height and base width of dentate process were negatively correlated with basilar depression and atlantoaxial dislocation(r=0.691,P<0.001).Sagittal joint obliquity was significantly positively correlated with basilar depression and atlantoaxial dislocation,while craniocervical obliquity was only significantly positively correlated with basilar depression(r=0.644,P<0.001).Conclusion Deformities of odontoid and lateral joint are the main causes of atlantoaxial dislocation in patients with basilar depression.

关 键 词：颅底凹陷 寰枢椎脱位 齿状突畸形 侧方关节畸形 相关性分析 

分 类 号：R682.1[医药卫生—骨科学]