颈椎X线参数测量及其对椎间盘假体设计的意义

发布时间：2018-07-03 00:28

本文选题：颈椎 + X线测量　；参考：《山东大学》2012年硕士论文

【摘要】：目的：通过对颈椎侧位X线片多项解剖学参数的测量及统计分析,了解不同颈椎节段的参数变化趋势及差异,为颈人工椎间盘假体设计提供理论数据。方法：选取山东大学齐鲁医院健康查体门诊行颈椎X线检查的健康查体者40例,均拍摄直立中立位颈椎侧位X线片。在影像工作站平台中分别测量椎体正中矢状径及中央高度,各椎间隙前缘、中央及后缘高度,椎体上、下终板的矢状径长度,椎体上、下终板角度,椎体上、下终板曲率半径,椎体上关节突角。测量长度精确至0.0lmm,测量角度精确至0.1。,并对测量数据进行统计分析。结果：1、椎体正中矢状径：C7C6C3C4C5, C3、C4、C5与C7间差异有统计学意义,余椎体间比较无统计学差异。 2、椎体中央高度：C7C3C4C5C6, C3、C4、C5、C6与C7间差异有统计学意义,余椎体间比较无统计学差异。 3、椎间隙高度：各椎间隙的中央高度前缘高度后缘高度,差异有统计学意义。各椎间隙中央高度间相互比较,C2/3、C3/4、C4/5、C5/6间隙间差异无统计学意义；其与C6/7间隙间比较,差异有统计学意义。 4、椎体上下终板的矢状径长度：同一椎间隙上终板下终板矢状径长度,差异无统计学意义。同一椎体下终板上终板矢状径长度,差异有统计学意义。 5、终板角度：椎体的上、下终板角度自C2至C7椎体分别依次递减。除C2/3间隙外,C3/4、C4/5、C5/6、C6/7各间隙下终板上终板角度,差异有统计学意义。同一椎体的上终板下终板角度,差异有统计学意义。 6、终板曲率半径：椎体的上、下终板曲率半径自C2至C7分别依次递增。同一椎间隙下终板上终板曲率半径,差异有统计学意义。同一椎体的上终板下终板曲率半径,差异有统计学意义。 7、上关节突角：自C2至C7以C5为中心呈U形分布,即C7C3C6C4C5,C7角度最大,其与C3、C4、C5、C6角度相互比较,差异有统计学意义。结论：通过对颈椎侧位X线片多项相关解剖学数据的测量,了解了不同节段解剖学参数的变化趋势及差异,从而在一定程度上为颈人工椎间盘假体的设计,包括假体的矢状径、高度、上下终板的形状及弧度、假体形状等方面提供理论参考数据,使椎间盘假体能够更好地恢复椎间隙高度,与椎体上下终板更好地匹配,更好地分散应力,以减少或避免假体植入后的各种后期并发症,提高颈人工椎间盘置换术的临床疗效。
[Abstract]:Objective: to study the variation trend and difference of cervical vertebrae parameters by measuring and analyzing the anatomical parameters of cervical lateral radiographs, and to provide theoretical data for the design of cervical artificial disc prosthesis. Methods: 40 cases of cervical vertebrae X-ray examination were selected from Qilu Hospital of Shandong University. The lateral cervical vertebrae radiographs were taken in the upright neutral position. The median sagittal diameter and height of the vertebral body, the anterior, central and posterior edge heights of the intervertebral space, the sagittal diameter length of the upper and lower endplates, the angle of the upper and lower endplates, the curvature radius of the upper and lower endplates of the vertebrae were measured in the imaging workstation platform, respectively. The angle of the upper articular process of the vertebral body. The measuring length is 0. 0lmm and the measuring angle is 0. 1. The measurement data are statistically analyzed. Results the median sagittal diameter of the vertebrae was: C7C6C3C4C5, C3C4C5 and C7, but there was no significant difference between the remaining vertebrae. 2. The central height of the vertebrae was: C7C3C4C5C6, C3C4C5C6 and C7, there was significant difference between C7C4C5C6 and C7C7C4C5C5. There was no statistical difference between the other vertebrae. 3. The height of the intervertebral space: the central height of the intervertebral space, the front height, the posterior edge height, the difference was statistically significant. There was no significant difference between C _ 2 / C _ 3 / C _ 3 / C _ 3 / C _ 4 / C _ 4 / C _ 4 / C _ 5 / 6 and C _ 6 / 7. 4. Sagittal diameter length of upper and lower endplate of vertebral body: the sagittal diameter length of inferior endplate of the same intervertebral space was not statistically significant. The sagittal diameter of superior endplate of the same vertebral body was significantly different. 5. Angle of endplate: the angle of upper and lower endplates of vertebral body decreased from C2 to C7 respectively. With the exception of C _ 2 / 3 gap, C _ 3 / 4 / C _ 4 / C _ 4 / C _ 5 / C _ 5 / C _ 5 / C _ 6 / 7, the difference is statistically significant. The angle of upper endplate and inferior endplate of the same vertebral body was significantly different. 6. Radius of curvature of endplate: the radius of curvature of upper and lower endplates of vertebral body increased from C2 to C7 respectively. The curvature radius of the superior endplate in the same intervertebral space was significantly different. The curvature radius of the upper and lower endplate of the same vertebral body was significantly different. 7. The angle of upper articular process: from C2 to C7 was U-shaped at the center of C5, that is, the angle of C7C3C6C4C5C5C7 was the largest, and the difference was statistically significant compared with that of C3C4C5C6. Conclusion: by measuring the relative anatomical data of lateral cervical X ray film, we can find out the change trend and difference of anatomical parameters in different segments, so as to design the prosthesis of cervical artificial intervertebral disc, including the sagittal diameter of the prosthesis, to a certain extent. The height, the shape and radians of the upper and lower endplates and the shape of the prosthesis provide theoretical reference data so that the intervertebral disc prosthesis can better restore the height of the intervertebral space, better match with the upper and lower endplates of the vertebral body, and distribute the stress better. In order to reduce or avoid all kinds of late complications after prosthesis implantation, improve the clinical effect of cervical artificial disc replacement.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.8

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