颈椎横突孔的CT影像学研究及临床意义

发布时间：2018-08-30 14:55

【摘要】：目的：调查国人横突孔变异的发生率,并通过测量CT上横突孔各径线数据,为颈椎前路手术提供参考。方法：收集2010年～2012年绍兴县中心医院的门诊和住院100例患者颈椎CT影像资料,其中男性53例,女性47例,年龄23～78岁,平均53.5岁,根据横突孔内缘与椎体外缘的关系将横突孔分为三种类型：椎体外型(A)、中间型(B)和椎体内型(C),并测量其C3-C6横突孔横径(a)、矢状径(b)、横突孔内缘间距(e)、横突孔内缘与椎体中线距离(d)、横突孔内缘与椎体外缘之间的距离(c)以及横突孔与椎管最短距离(f)6个参数,比较横突孔两侧及各椎体之间有无差别,分析测量的意义。结果： (1)横突孔椎体外型、中间型及椎体内型分别占83.34%、16.37%、0.29%,其中有2个横突孔明显突入椎体。(2)横突孔孔径测量结果显示左侧横径为0.68±0.19cm、失状径为0.56±0.18cm、横突孔内缘与椎体外缘距离为0.14+0.20cm、横突孔内缘与椎体中线距离为1.30±0.28cm、横突孔与椎管最短距离为0.48±0.18cm；右侧横径为0.65±0.17cm、失状径为0.53±0.17cm、横突孔内缘与椎体外缘距离为0.16±0.21cm、横突孔内缘与椎体中线距离为1.28±0.30cm、横突孔与椎管最短距离为0.46±0.18cm；横突孔内缘间距为2.57±0.18cm。其中横突孔内缘与椎体外缘之间的距离有部分椎体由于边缘不清晰无法测量,所测数据较少。(3)统计分析结果显示同一椎体双侧横突孔对比矢状径C4左侧右侧、C5左侧右侧；同侧椎体横突孔相互比较横径左侧C5C3,右侧C5C4、C6C4,失状径双侧均为C3C5、C3C6、C4C5、C4C6;横突孔至中线距离、横突孔至椎管最短距离及横突孔内缘间距双侧均为C3C5C6、C4C5C6,其差别均具有显著性意义结论： (1)除C3、C4之间差别不显著外,C3～C6横突孔间距及横突孔与椎管最短距离自上而下逐渐增加。(2)极少数横突孔内缘可能越过椎体外缘至椎体内；；(3)颈椎前路手术过程中术者应仔细做好术前检查,以避免术中的椎动脉损伤,并有助于指导手术。
[Abstract]:Objective: to investigate the incidence of variation of transverse process foramen in Chinese, and to provide reference for anterior cervical vertebra operation by measuring the diameter of superior transverse process foramen of CT. Methods: from 2010 to 2012, 100 CT images of cervical vertebrae in outpatients and inpatients of Shaoxing County Central Hospital were collected, including 53 males and 47 females, aged 2378 years (mean 53.5 years). According to the relationship between the inner edge of the transverse foramen and the outer edge of the vertebral body, the transverse foramen of the transverse process is divided into three types: the external type of vertebral body (A), intermediate type (B) and the intraspinal type of (C),. The transverse diameter of C3-C6 transverse process foramen (a), sagittal diameter (b), transverse process foramen inner margin spacing (e), transverse process foramen and the inner border of (e), transverse process foramen are measured. The distance between the midline of the vertebral body and the inner edge of the transverse process foramen of (d), and the outer edge of the vertebral body, (c), and the shortest distance between the transverse foramen and the spinal canal, six parameters, (f), were analyzed. To compare the differences between the two sides of the transverse foramen and the vertebrae, and to analyze the significance of measurement. Results: (1) the shape of transverse foramen vertebrae, (2) the diameter of the transverse process foramen was 0.68 卤0.19 cm, the lost diameter was 0.56 卤0.18 cm, the distance between the inner edge of the transverse process foramen and the outer edge of the vertebral body was 0.14 0.20 cm, and the inner margin of the transverse process foramen was 0.14 0.20 cm. The diameter of the transverse process foramen was 0.68 卤0.19 cm, the lost diameter was 0.56 卤0.18 cm, the distance between the inner edge of the transverse process foramen and the outer edge of the vertebral body was 0.14 0.20 cm. The midline distance was 1.30 卤0.28 cm, and the shortest distance between transverse foramen and spinal canal was 0.48 卤0.18 cm. The transverse diameter of the right side was 0.65 卤0.17 cm, the lost diameter was 0.53 卤0.17 cm, the distance between the inner edge of the transverse process foramen and the outer edge of the vertebral body was 0.16 卤0.21 cm, the distance between the inner edge of the transverse process foramen and the middle line of the vertebral body was 1.28 卤0.30 cm, the shortest distance between the transverse process foramen and the vertebral canal was 0.46 卤0.18 cm, and the distance between the inner edge of the transverse process foramen and the inner edge of the transverse process foramen was 2.57 卤0.18 cm. The distance between the inner edge of the transverse foramen and the outer edge of the vertebral body is part of the vertebral body can not be measured because the edge is not clear, the measured data are less. (3) the statistical analysis shows that the bilateral transverse process foramen of the same vertebral body contrast sagittal diameter C 4 left right side, right side C 5; The transverse foramen of the ipsilateral vertebral body was compared with that of the transverse process foramen. The transverse diameter of the ipsilateral vertebral body was compared with that of the left C5C3and the right C5C4C4C4C4C4C4C6. the distance between the transverse foramen and the midline of the transverse process foramen was the distance between the transverse foramen and the midline. The shortest distance from transverse process foramen to spinal canal and the distance between transverse process foramen and internal margin of transverse process foramen were both C3C5C6C4C5C6. The differences were significant. Conclusion: (1) there was no significant difference in the distance between transverse process foramen and transverse process foramen except C3C5C6C6C5C6. (1) there was no significant difference in the distance between transverse process foramen and transverse process foramen except C3C5C6. The shortest distance from the vertebral canal to the spinal canal increased gradually. (2) the inner edge of a few transverse process foramen may cross the outer edge of the vertebral body to the vertebral body; In order to avoid the injury of vertebral artery during anterior cervical surgery, the operative should carefully make the preoperative examination, and be helpful to guide the operation.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R687.3;R816.8

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