| 阎崇楠,王欢,李雷,崔少千,祁英,徐昕,段景柱,金国鑫,张磊,陈健华,李成.寰椎后弓-横突髓腔钉道的影像解剖学参数及其临床意义[J].脊柱外科杂志,2018,16(2):92-97. |
寰椎后弓-横突髓腔钉道的影像解剖学参数及其临床意义  点此下载全文 (Fulltext) |
| 阎崇楠1 王欢1 李雷1 崔少千1 祁英2 徐昕3 段景柱1 金国鑫1 张磊1 陈健华1 李成1 |
1. 中国医科大学附属盛京医院脊柱外科, 辽宁 110004;
2. 中国医科大学附属盛京医院影像科, 辽宁 110004;
3. 中国医科大学附属盛京医院临床流行病学教研室, 辽宁 110004 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2018.02.007 |
| 摘要点击次数: 552 |
| 全文下载次数: 558 |
| 摘要： |
| 目的 通过影像归档和通信系统（PACS）测量成人寰椎后弓-横突髓腔钉道的解剖学参数，并结合临床病例探讨其临床意义。方法 选择2016年1月—2017年6月本院PACS中18~70岁患者的颈椎三维CT数据，共200例，男女各100例，年龄（54.95±11.93）岁。选取寰椎后弓-横突髓腔最长轴切面为测量截面，利用PACS测量软件手工测量该截面入钉点与后结节距离、入钉角度与矢状面夹角、入钉角度与横截面夹角、钉道长度、椎动脉沟狭窄处髓腔高度和入钉点髓腔最大高度等解剖学参数，所得数据纳入统计学分析。结合临床病例探讨其可行性。结果 入钉点与后结节距离为（7.45±1.75）mm，入钉角度与矢状面夹角为54.26°±6.06°，入钉角度与横截面夹角为9.15°±3.40°、钉道长度为（18.55±3.75）mm，椎动脉沟狭窄处髓腔高度为（2.09±0.81）mm，入钉点髓腔最大高度为（4.93±0.37）mm。男性寰椎后弓-横突髓腔钉道在入钉点与后结节距离、钉道长度、椎动脉沟狭窄处髓腔高度和入钉点髓腔最大高度均大于女性，差异有统计学意义（P< 0.05），不同性别之间入钉角度与矢状面夹角和入钉角度与横截面夹角差异无统计学意义（P>0.05）。经有限病例初步证实该置钉方式具有可行性。结论 寰椎后弓-横突髓腔的解剖学特点能够满足置钉要求，在常规寰椎椎弓根螺钉进钉点狭小无法置钉或钉道破裂置钉失败时，可以当做替代置钉钉道方案。 |
| 关键词：寰椎 解剖学 放射摄影术 |
| Anatomical parameter on image of intramedullary trajectory of posterior arch-transverse process of atlas and its clinical signifcance Fulltext |
| YAN Chong-nan1 WANG Huan1 LI Lei1 CUI Shao-qian1 QI Ying2 XU Xin3 DUAN Jing-zhu1 JIN Guo-xin1 ZHANG Lei1 CHEN Jian-hua1 LI Cheng1 |
1. Department of Spinal Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning, China;
2. Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning, China;
3. Department of Clinical Epidemiology, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning, China |
| Fund Project: |
| Abstract: |
| Objective To measure the anatomical parameters of intramedullary trajectory of posterior arch-transverse process of the atlas in adults through picture archiving and communication system(PACS), and discuss its clinical significance by combining with clinical cases. Methods The data were transmitted onto the PACS, including 200 adults who received three-dimensional CT scan of the cervical spine. There were 100 cases each in male and female groups, and the average age was (54.95±11.93)years. The longest axis of the medullary cavity of posterior arch-transverse process of the atlas was chosen as the measurement section. The relative parameters including distance between the entry point and posterior tubercle, angle between the trajectory and sagittal section, angle between the trajectory and transverse section, length of the trajectory, height of minimal medullary cavity of the vertebral artery groove and height of maximal medullary cavity of the entry point were measured manually. Statistical analysis was then performed to obtain the general mean and standard deviation, and to compare between the male and female subjects. The feasibility of the method was explored through clinical cases. Results The distance between the entry point and posterior tubercle was (7.45±1.75)mm, angle between the trajectory and sagittal section 54.26°±6.06°, angle between the trajectory and transverse section 9.15°±3.40°, length of the trajectory (18.55±3.75)mm, height of minimal medullary cavity of the vertebral artery groove (2.09±0.81)mm and height of maximal medullary cavity of the entry point (4.93±0.37)mm. The distance between the entry point and posterior tubercle, length of the trajectory, height of minimal medullary cavity of the vertebral artery groove and height of maximal medullary cavity of the entry point of the males were significantly higher than those of the females, and the differences were statistically significant(P< 0.05). There was no difference between the males and females in angle between the trajectory and sagittal section or angle between the trajectory and transverse section. The feasibility of the method was preliminarily confirmed by limited cases. Conclusion The anatomical parameters of the intramedullary trajectory of posterior arch-transverse process of the atlas can meet the requirement of screw implantation, which provides an alternative solution of the trajectory when the pedicle screw insertion failed. |
| Keywords:Atlas Anatomy Radiography |
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