C_(2/3)经关节突经椎弓根螺钉固定的影像学测量及可行性分析  

Imaging measurement and feasibility analysis of C_(2/3)transarticular transpedicular screw

作　　者：陈钧麟 马向阳[1,2] 邹小宝 付索超 朱昌荣 邓琛府 马仁财 陈泽星 夏虹 Chen Junlin;Ma Xiangyang;Zou Xiaobao;Fu Suochao;Zhu Changrong;Deng Chenfu;Ma Rencai;Chen Zexing;Xia Hong(Southern Medical University,Guangzhou 510515,China;Department of Orthopedics,General Hospital of Southern Theatre Command of PLA,Guangzhou 510010,China)

机构地区：[1]南方医科大学,广州510515 [2]中国人民解放军南部战区总医院骨科,广州510010

出　　处：《中国临床解剖学杂志》2024年第2期126-130,139,共6页Chinese Journal of Clinical Anatomy

基　　金：广州市科技计划项目(201803010046);国家自然科学基金(82272582)。

摘　　要：目的测量C_(2/3)经关节突经椎弓根螺钉相关影像学指标,并分析该置钉技术的可行性。方法收集120例全颈椎CT薄层扫描数据,其中男性75例,女性45例。设定C_(2/3)经关节突经椎弓根螺钉的进钉点,即进钉点在枢椎侧块的水平中线与中外1/3垂线交点处,螺钉自枢椎侧块穿C_(2/3)关节突关节、C_(3)侧块止于C_(3)椎弓根下缘。测量C_(2/3)经关节突经椎弓根螺钉相关影像学数据,包括C_(3)椎弓根宽度与高度,螺钉通道长度,内倾角度,头倾角度,最狭窄处宽度。并分析各项测量结果之间的关系。结果C_(3)椎弓根平均宽度5.48 mm,平均高度6.82 mm,螺钉通道平均长度18.68 mm,平均内倾角度20.46°,平均头倾角度50.1°,最狭窄处平均宽度2.80 mm。C_(3)椎弓根宽度与高度呈正相关(P=0.000),螺钉通道长度与C_(3)椎弓根宽度、高度呈正相关(P=0.000;P=0.000),螺钉通道最狭窄处宽度与C_(3)椎弓根宽度、高度呈正相关(P=0.000;P=0.000)。240例置钉测量数据中,如使用3.5 mm直径螺钉,均可完成置钉,C_(2/3)经关节突经椎弓根螺钉适用于所有患者。结论C_(2/3)经关节突经椎弓根螺钉在解剖学上是可行的,可作为上颈椎后路钉棒内固定补充的置钉技术。Objective To measure the imaging indexes of C_(2/3)transarticular transpedicular screw,and analyze the feasibility of this screw placement technique.Methods The CT data of 120 thin slice CT scan were collected,including 75 males and 45 females.The entry point of the C_(2/3)transarticular transpedicular screw was set,that is,the entry point was at the intersection of the horizontal midline and the mid-lateral 1/3vertical line of the lateral mass of the axis.The screw passed through the facet joint of C_(2/3)and the C_(3)lateral mass,from the lateral mass of the axis,and ended at the inferior edge of the pedicle of C_(3).The imaging data of C_(2/3)transarticular transpedicular screw were measured,including C_(3)pedicle width and height,screw channel length,introversion angle,head tilt angle and the narrowest width.The relationship between the measurement results was analyzed.Results The average width of C_(3)pedicle was 5.48mm,the average height was 6.82mm,the average screw channel length was 18.68mm,the average introversion angle of screw channel was20.46°,the average head tilt angle was 50.1°,and the average width of the narrowest part was 2.80 mm.There was a positive correlation between C_(3)pedicle width and height(P=0.000).The length of screw channel was positively correlated with C_(3)pedicle width and height(P=0.000;P=0.000).The width of the narrowest part of screw channel was positively correlated with C_(3)pedicle width and height(P=0.000;P=0.000).In the measurement data of 240 cases,the screw placement could be completed if 3.5 mm diameter screws were used,and the screw was suitable for all patients.Conclusions C_(2/3)transarticular transpedicular screw is anatomically feasible and can be used as a supplementary technique for posterior screw rod internal fixation of upper cervical spine.

关 键 词：枢椎 影像学测量 C_(2/3)经关节突经椎弓根螺钉 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学] R826.24[医药卫生—基础医学]