本文選題：下頸椎 + 椎弓根螺釘��； 參考：《第二軍醫(yī)大學(xué)學(xué)報(bào)》2017年09期

【摘要】：目的對下頸椎椎弓根前入口及椎弓根前半的四壁皮質(zhì)厚度行CT影像學(xué)測量,為前路椎弓根釘準(zhǔn)確置入提供參考。方法對10例正常新鮮尸體的頸椎標(biāo)本進(jìn)行CT掃描并重建圖像。用AutoCAD 2007軟件的"對齊標(biāo)注"測量下頸椎椎弓根前入口上(SAE)、內(nèi)(MAE)、下(IAE)和外(LAE)以及椎弓根前半上(SPA)、內(nèi)(MPA)、下(IPA)和外(LPA)的皮質(zhì)厚度(精確度0.1mm),并對測量結(jié)果進(jìn)行比較分析。結(jié)果 C3~7左側(cè)和右側(cè)的平均SAE、MAE、IAE、LAE、SPA、MPA、IPA及LPA厚度分別為(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。同一頸椎同一測量指標(biāo)的左、右側(cè)比較差異均無統(tǒng)計(jì)意義(P0.05)。對同一頸椎同側(cè)的不同測量指標(biāo)行單因素隨機(jī)區(qū)組方差分析,結(jié)果示LAE與LPA最薄,均薄于其他6個測量指標(biāo),差異有統(tǒng)計(jì)學(xué)意義(P均0.01),而LAE與LPA厚度之間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論下頸椎椎弓根LAE及LPA較其他側(cè)壁皮質(zhì)菲薄,如皮質(zhì)厚度與抵抗外力強(qiáng)度一致,則LAE和LPA抵抗外力的強(qiáng)度最小。提示頸前路椎弓根螺釘固定尋找前入口時應(yīng)避免靠近LAE,在螺釘置入過程中應(yīng)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 鹵0.6 and 1.9 鹵0.5 鹵0.7 in the left and right sides, respectively, and 2.4 鹵0.5 鹵0.9 鹵0.5 鹵0.9 鹵0.9 鹵0.9 鹵0.9 鹵0.9 鹵0.9 鹵0.9 鹵0.9 鹵0.9 鹵0.9 鹵0.9 鹵0.9 鹵0.63 鹵0.9) and 2.1 鹵0.7 鹵0.8) and 2.2 鹵0.8, 2.2 鹵0.8 and 1.0 鹵0.6 mm respectively in the left and right sides of C3H7, and 2.1 鹵0.7 鹵0.8 and 2.2 鹵0.8 and 1.0 鹵0.6 mm respectively in the left and right sides of C3H7, and 2.1 鹵0.7 鹵0.8, 2.2 鹵0.7 and 1.0 鹵0.6mmmmmm. respectively, the mean thickness of SPAMPAIPA and LPA in the right and the left were 1.9 鹵0.6, 1.9 鹵0.5, and 2.4 鹵0.5 鹵0.5, and 0.9 鹵0.5 鹵0.9) and 2.3 鹵0.7, and 2.1 鹵0.7 and 2.2 鹵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.
【作者單位】： 海軍總醫(yī)院骨科;海軍總醫(yī)院放射科;
【基金】：海軍總醫(yī)院創(chuàng)新培育基金(CXPY2014-13)~~
【分類號】：R687.3

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