目的 使用CT影像解剖测量及数字三维重建探究新型枢椎棘突椎板螺钉固定的可行性。方法 收集120例成人（男59例，女61例）的颈椎CT数据，使用Dicom格式导入Mimics 21.0软件进行重切片及数据测量、三维重建及模拟置钉。测量数据包含枢椎椎板厚度、高度及长度、棘突根部宽度、模拟的螺钉长度、螺钉内倾及头倾角度、椎板与矢状面的夹角。分析枢椎棘突椎板螺钉置钉的可行性。 结果 左右两侧的测量数据差异均无统计学意义（P>0.05）。男性、女性枢椎椎板高度、厚度、长度以及棘突宽度、螺钉长度比较，差异均有显著差异（P<0.05）；男性、女性的螺钉的头倾、内倾角度，以及椎板与矢状面角度差异无统计学意义（P>0.05）。新型枢椎棘突椎板螺钉的钉道长度男性为(27.16±3.92) mm，女性为(23.90±4.25) mm，螺钉内倾角度为(61.88±6.93) °，螺钉头倾角度为(28.26±5.95) °。枢椎棘突椎板螺钉的钉道长度与椎板高度及下部厚度呈中等正相关，与椎板上、中部厚度呈强正相关。 结论 新型枢椎棘突椎板螺钉在影像学解剖研究上是可行的，CT测量及计算机模拟置钉的结果为后续的生物力学研究及临床应用提供了理论支持。
Abstract
Objective To explore the feasibility of the novel C2 spinous lamina screw by using anatomical measurements on CT images and digital three-dimensional reconstruction. Methods Cervical CT data from 120 adults (59 males and 61 females) were collected and imported into Mimics 21.0 software using Dicom format for slicing and data measurement, 3D reconstruction and simulated screw placement. The thickness of C2 lamina, the height of C2 lamina, the length of C2 lamina, the width of the spinous root, the length of the simulated screw trajectory, the angle of inversion of the screw, the angle of inclination of the screw head, and the angle between the lamina and the sagittal plane were measured. The feasibility of the novel C2 spinous lamina screw placement was analyzed. Results There was no statistical difference between the measured data on both sides (P>0.05). There were significant differences in the height, thickness, and length of the C2 lamina, as well as the width of the spinous process and the length of the screw path between males and females (P<0.05). There were no significant differences in the uptilt angle of the screw, the medial tilt angle of the screw, and angle between lamina and sagittal plane of screws between male and female (P>0.05). The screw path length of the novel C2 spinous lamina screw was (27.16±3.92) mm for males and (23.90±4.25) mm for females, the medial tilt angle of the screw was (61.88±6.93) °, and the uptilt angle of the screw was (28.26±5.95) °. The length of the screw path of the novel C2 spinous lamina screw was moderately positively correlated with the height of the lamina and the thickness of the lower part of the lamina, and strongly positively correlated with the thickness of the upper and middle lamina. Conclusions The novel C2 spinous lamina screw is feasible in the study of imaging anatomy, and the results of CT measurement and computer simulation provide theoretical support for the subsequent biomechanical research and clinical application.
关键词
寰枢椎脱位 /
新型枢椎棘突椎板螺钉 /
CT /
/
/
解剖学
Key words
Atlantoaxial dislocation /
The novel C2 spinous lamina screw /
CT /
Anatomy
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基金
国家自然科学基金面上项目(82272582)
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