目的 通过测量正常人群颈椎解剖学参数，为设计新型双螺纹椎弓根螺钉提供理论依据。方法 纳入100名健康人群，完善颈椎CT扫描，在CT片上分别测量C3~7的双侧椎弓根螺钉进钉路径长度（包括椎体内长度、椎弓根长度、椎板长度，作为椎弓根螺钉长度设计参考）、进钉外展角和椎弓根峡部的宽度和高度（作为椎弓根螺钉直径设计参考）。计算各测量结果的均值及四分位数。 结果 纳入成年健康志愿者100人的基本信息，包括身高、年龄，体重，合并疾病，其中男54例，女46例，平均年龄35.95岁。从C3~7，各参数左右两侧对比，差异无统计学意义（P>0.05），男女间对比，差异无统计学意义（P>0.05）下颈椎椎弓根螺钉进钉路径椎体平均长度（15.85±1.20）~（19.40±1.50）mm；椎弓根平均长度（5.42±1.06）~（6.03±0.84）mm；椎板平均长度（9.52±1.15）~（10.33±1.58）mm。进钉外展角平均值范围（39.82±2.53）°~（42.56±2.50）°；椎弓根峡部宽度平均值（5.84±0.87）~（7.10±1.05）mm；椎弓根峡部高度平均值（6.71±1.10）~（8.26±1.22）mm。 结论 通过对正常人群颈椎C3~C7椎弓根螺钉进钉相关解剖参数的测量，为设计新型双螺纹颈椎椎弓根螺钉提供了理论依据。
Abstract
Objective To provide theoretical basis for the design of new double threaded pedicle screws, by measuring the anatomical parameters of cervical vertebrae in normal people. Methods A total of 100 healthy individuals were collected and the cervical spine CT scan were completed. The length of bilateral pedicle screw insertion path (including intra-vertebral length, pedicle length, and vertebral plate length, as reference for pedicle screw length design), insertion abduction angle, and width and height of pedicle isthmus (as reference for pedicle screw diameter design) of C3~7 on CT scan. The mean value and quartile of each measurement result were calculated. Results Basic information of 100 adult healthy volunteers, including height, age, weight, and comorbidities, including 54 males and 46 females, with an average age of 35.95 years were recorded. From the CT scan of C3~7, there was no statistical difference between the left and right sides of each parameter (P>0.05). There was no statistical difference in male and female (P>0.05). The average length of the vertebral body in the lower cervical pedicle screw insertion path was (15.85±1.20)~(19.40±1.50) mm. The average length of the pedicle was (5.42±1.06)~(6.03±0.84) mm. The average length of the vertebral lamina was (9.52±1.15)~(10.33±1.58) mm. The average range of nail insertion and abduction angle was (39.82±2.53) °~(42.56±2.50) °. The average width of the pedicle isthmus was (5.84±0.87)~(7.10±1.05) mm. The average height of the pedicle isthmus was (6.71±1.10)~(8.26±1.22) mm. Conclusions The measurement of the anatomical parameters related to C3~C7 pedicle screw fixation in normal people provides theoretical basis for the design of a new type of double-threaded pedicle screw.
关键词
下颈椎； /
/
解剖学测量； /
/
双螺纹椎弓根螺钉
Key words
Lower cervical vertebra; /
/
Anatomical measurement; /
/
Double- threaded pedicle screw
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Hachan S, Bin Abd Razak HR, Loo WL, et al. Cervical pedicle screw instrumentation is more reliable with O-arm-based 3D navigation: analysis of cervical pedicle screw placement accuracy with O-arm-based 3D navigation[J]. Eur Spine, 2018, 27:2729-2736. DOI: 10.1007/s00586-018-5585-1.
[2] Kast E, Mohr K, Richter HP, et al. Complications of transpedicular screw fixation in the cervical spine[J]. Eur Spine, 2006, 15:327-334. DOI: 10.1007/s00586-004-0861-7.
[3] Kotani Y, Abumi K, Ito M, et al. Improved accuracy of computer-assisted cervical pedicle screw insertion [J]. Neurosurgery, 2003, 99(3 Suppl):257–263. DOI: 10.3171/spi.2003.99.3.0257.
[4] Jeanneret B, Gebhard JS, Magerl F. Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique. [J] Spinal Disord,1994,7:222–229. DOI: 10.1097/00002517-199407030-00004.
[5] Jones EL, Heller JG, Silcox DH, et al. Cervical pedicle screws versus lateral mass screws. Anatomic feasibility and biomechanical comparison[J]. Spine (Phila Pa 1976), 1997, 22(9):977-982. DOI: 10.1097/00007632-199705010-00009
[6] Gelalis ID, Paschos NK, Pakos EE, et al. Accuracy of pedicle screw placement: a systematic review of prospective in vivo studies comparing free hand, fluoroscopy guidance and navigation techniques[J]. Eur Spine,2012, 21:247-255. DOI: 10.1007/s00586-011-2011-3.
[7] Barrey C, Cotton F, Jund J, et al. Transpedicular screwing of the seventh cervical vertebra: anatomical considerations and surgical technique [J]. Surg Radiol Anat, 2003, 25(5,6):354-360. DOI: 10.1007/s00276-003-0163-5.
[8] Jeanneret B, Gebhard JS, Magerl F. Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique [J]. Spinal Disord,1994,7(3):222-229. DOI: 10.1097/00002517-199407030-00004.
[9] Karami KJ, Buckenmeyer LE, Kiapour AM, et al. Biomechanical evaluation of the pedicle screw insertion depth effect on screw stability under cyclic loading and subsequent pullout[J]. Spinal Disord Tech, 2015, 28(3):E133-E139. DOI: 10.1097/BSD.0000000000000178.
[10] Ebraheim NA, Xu R, Knight T, et al. Morphometric evaluation of lower cervical pedicle and its projection [J]. Spine, 1997, 22(1):1-6. DOI: 10.1097/00007632-199701010-00001.
[11] Jeanneret B, Gebhard JS, Magerl F. Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique[J]. Spinal Disord, 1994, 7(3):222-229. DOI: 10.1097/00002517-199407030-00004.
[12]康意军, 陈飞, 吕国华, 等. 颈椎椎弓根钉在强直性脊柱炎颈椎骨折 中的应用[J].中南大学学报(医学版), 2005, 30(6):700-703.
[13] Westermann L, Spemes C, Eysel P, et al. Computer tomography-based morphometric analysis of the cervical spine pedicles C3-C7[J]. Acta Neurochir (Wien), 2018,160:863-871. DOI: 10.1007/s00701-018-3481-4.
[14]Chanplakorn P, Kraiwattanapong C, Aroonjarattham K, et al. Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT) scan: the consideration for cervical pedicle screws fixation[J]. BMC Musculoskelet Disord, 2014, 15:125. DOI: 10.1186/1471-2474-15-125.
[15] Krenn MH, Piotrowski WP, Penzkofer R, et al. Influence of thread design on pedicle screw fixation. Laboratory investigation [J].Neurosurg Spine, 2008, 9(1):90-95. DOI: 10.3171/SPI/2008/9/7/090.
基金
中央引导地方科技发展资金（20222ZDH04095）；江西省重点研发计划项目（20223BBG71S02）
PDF(1677 KB)
京ICP备08002354号-3
