【摘要】：目的:按下頸椎椎弓根置釘方法(局部解剖定位法)的參數(shù)在計算機(jī)工作站上對C3、C4、C5椎弓根進(jìn)行影像學(xué)測量,并與解剖學(xué)測定的參數(shù)進(jìn)行比對、分析,以期為進(jìn)一步的軟件開發(fā)提供理論依據(jù)和數(shù)據(jù)庫。方法:選取我院2014年10月-2016年10月在骨科住院的頸椎CT檢查資料,共40例,并在計算機(jī)工作站上進(jìn)行三維重建,其中男性20例,女性20例,年齡在18-70歲,平均46.98±14.10歲,排除頸椎椎弓根畸形、破壞(外傷、感染、腫瘤侵蝕)的患者。按照下頸椎C3-C5椎弓根置釘方法(局部解剖定位法)的參考系選擇進(jìn)釘點,在工作站測量C3-C5椎弓根最狹窄處高度(PH)、椎弓根最狹窄處寬度(PW)、在水平面上與“峽部”的后外側(cè)面形成的橫向角(E)、在矢狀面上與“峽部”后側(cè)面形成的縱向角(F),并與解剖學(xué)測定的參數(shù)進(jìn)行比對、分析,使用SPSS軟件對所得數(shù)據(jù)進(jìn)行統(tǒng)計分析。結(jié)果:1.同一節(jié)段,椎弓根高度(PH)大于寬度(PW),經(jīng)t檢驗有差異性(P0.05)。2.C3-C5椎弓根高度(PH)、寬度(PW),同性左、右側(cè)間差異不顯著P0.05,通過對比發(fā)現(xiàn)男性女性,經(jīng)t檢驗有差異性(P0.05),且工作站測量的數(shù)據(jù)與解剖學(xué)研究的數(shù)據(jù)之間也存在差異(P0.05)。3.C3-C5椎弓根橫向角(E)、縱向角(F),同一節(jié)段左、右側(cè)之間、性別之間比較差異不顯著(P0.05);男性椎弓根橫向角(E)、縱向角(F)與女性的數(shù)值近似,且工作站測量的數(shù)據(jù)與解剖學(xué)研究的數(shù)據(jù)之間的差異亦不顯著(P0.05)。結(jié)論:1.C3、C4、C5椎弓根在固定的參考系、進(jìn)釘點的情況下,橫向角(E)、縱向角(F)是相對不變的,表明在解剖學(xué)研究的基礎(chǔ)上提出的下頸椎椎弓根置釘方法(局部解剖定位法)確實可行。2.數(shù)字影像輔助技術(shù)(CT工作站)可使椎弓根數(shù)據(jù)達(dá)到個性化要求。
[Abstract]:Objective: to measure C3C4C5 pedicle in computer workstation according to the parameters of pedicle screw insertion (local anatomic localization), and to compare and analyze the parameters of C3C4C5 pedicle. In order to provide theoretical basis and database for further software development. Methods: a total of 40 cases of cervical spine CT were selected from Oct 2014 to Oct 2016 in our hospital, and were reconstructed on computer workstation. There were 20 males and 20 females, aged 18-70 years, with an average of 46.98 鹵14.10 years old. Exclusion of cervical pedicle malformation, destruction (trauma, infection, tumor erosion) patients. According to the reference system of lower cervical C3-C5 pedicle screw insertion (local anatomical localization), the point of insertion was selected. The height of C3-C5 pedicle at the narrowest point, the width of (PW), at the narrowest part of the pedicle, and the transverse angle (E), formed on the horizontal plane with the posterior lateral side of the isthmus on the sagittal plane and the longitudinal angle (F), formed on the posterior side of the isthmus were measured at the workstation. Compared with anatomical parameters, Analysis, the use of SPSS software for statistical analysis of the data. The result is 1: 1. In the same segment, (PH) of pedicle height was larger than width (PW), by t test (P0.05). 2.The width of (PW), of pedicle height of C3-C5 was the same as that of left, but there was no significant difference between right side and left side (P 0.05). T test showed difference (P0.05), and there was also difference between the data measured by workstation and anatomical study data (P0.05) .3.C3-C5 pedicle transverse angle (E), longitudinal angle (F), of the same segment between left and right. There was no significant difference between male and female (P0.05); male pedicle transverse angle (E), longitudinal angle (F) was similar to that of female, and the difference between workstation data and anatomical data was not significant (P0.05). Conclusion 1. The lateral angle of (E), longitudinal angle (F) is relatively unchanged when the pedicle of C _ 3 C _ 4 C _ 5 pedicle is fixed in the reference system and the point of insertion, which indicates that the method of pedicle screw insertion (local anatomical orientation method) proposed on the basis of anatomical study is feasible. Digital image aided technology (CT workstation) can make pedicle data personalized.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3

【參考文獻(xiàn)】

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1 姜良海;譚明生;楊峰;移平;唐向盛;韋z延，

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