下颈椎椎弓根前入口及前半四壁皮质厚度的影像学测量及应用分析

发布时间：2018-05-19 12:27

本文选题：下颈椎 + 椎弓根螺钉　；参考：《第二军医大学学报》2017年09期

【摘要】：目的对下颈椎椎弓根前入口及椎弓根前半的四壁皮质厚度行CT影像学测量,为前路椎弓根钉准确置入提供参考。方法对10例正常新鲜尸体的颈椎标本进行CT扫描并重建图像。用AutoCAD 2007软件的"对齐标注"测量下颈椎椎弓根前入口上(SAE)、内(MAE)、下(IAE)和外(LAE)以及椎弓根前半上(SPA)、内(MPA)、下(IPA)和外(LPA)的皮质厚度(精确度0.1mm),并对测量结果进行比较分析。结果 C3~7左侧和右侧的平均SAE、MAE、IAE、LAE、SPA、MPA、IPA及LPA厚度分别为(1.9±0.6)和(1.9±0.5)mm、(1.9±0.7)和(1.9±0.4)mm、(2.4±0.6)和(2.4±0.5)mm、(0.9±0.5)和(0.9±0.6)mm、(2.3±0.9)和(2.3±0.7)mm、(2.1±0.5)和(2.1±0.6)mm、(2.2±0.8)和(2.2±0.7)mm及(1.0±0.7)和(1.0±0.6)mm。同一颈椎同一测量指标的左、右侧比较差异均无统计意义(P0.05)。对同一颈椎同侧的不同测量指标行单因素随机区组方差分析,结果示LAE与LPA最薄,均薄于其他6个测量指标,差异有统计学意义(P均0.01),而LAE与LPA厚度之间差异无统计学意义(P0.05)。结论下颈椎椎弓根LAE及LPA较其他侧壁皮质菲薄,如皮质厚度与抵抗外力强度一致,则LAE和LPA抵抗外力的强度最小。提示颈前路椎弓根螺钉固定寻找前入口时应避免靠近LAE,在螺钉置入过程中应避免靠近LPA。
[Abstract]:Objective to measure the thickness of the anterior entrance of the lower cervical pedicle and the anterior half of the pedicle of the lower cervical vertebrae by CT imaging, so as to provide a reference for the anterior pedicle screw placement. Methods CT scan and reconstruction of cervical vertebrae of 10 normal fresh cadavers were performed. The cortical thickness (accuracy of 0.1 mm) of the anterior entrance of the lower cervical pedicle was measured by "alignment labeling" by AutoCAD 2007 software. The cortical thickness of the anterior superior pedicle of the lower cervical vertebrae was measured, and the results were compared with that of the external LPAs. The cortical thickness of the anterior half of the pedicle of the lower cervical vertebrae was measured by AutoCAD 2007 software, and the cortical thickness of the anterior half of the pedicle of the vertebrae was measured with the accuracy of 0.1 mm. Results the average thickness of SAEMAEMAEPAMPAIPA and LPA were 1.9 卤0.6 and 1.9 卤0.5 卤0.7 in the left and right sides, respectively, and 2.4 卤0.5 卤0.9 卤0.5 卤0.9 卤0.9 卤0.9 卤0.9 卤0.9 卤0.9 卤0.9 卤0.9 卤0.9 卤0.9 卤0.9 卤0.9 卤0.63 卤0.9) and 2.1 卤0.7 卤0.8) and 2.2 卤0.8, 2.2 卤0.8 and 1.0 卤0.6 mm respectively in the left and right sides of C3H7, and 2.1 卤0.7 卤0.8 and 2.2 卤0.8 and 1.0 卤0.6 mm respectively in the left and right sides of C3H7, and 2.1 卤0.7 卤0.8, 2.2 卤0.7 and 1.0 卤0.6mmmmmm. respectively, the mean thickness of SPAMPAIPA and LPA in the right and the left were 1.9 卤0.6, 1.9 卤0.5, and 2.4 卤0.5 卤0.5, and 0.9 卤0.5 卤0.9) and 2.3 卤0.7, and 2.1 卤0.7 and 2.2 卤0.8, respectively. There was no statistical significance between the left and right sides of the same cervical spine. The results of ANOVA showed that LAE and LPA were thinnest than the other 6 indexes, and the difference was statistically significant (P < 0.01), but there was no significant difference between LAE and LPA thickness (P 0.05). Conclusion LAE and LPA of lower cervical pedicle are thinner than other lateral wall cortex. If the thickness of cortex is the same as the strength of resisting external force, LAE and LPA have the least resistance to external force. It is suggested that the anterior approach to LAE should be avoided in anterior pedicle screw fixation and LPA should be avoided during screw placement.
【作者单位】：海军总医院骨科;海军总医院放射科;
【基金】：海军总医院创新培育基金(CXPY2014-13)~~
【分类号】：R687.3

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