目的 通过测量正常国人的颈椎椎间隙解剖学参数，为设计符合国人的颈椎前路零切迹椎间融合器提供理论依据。 方法 纳入200例健康志愿者，在标准颈椎正侧位X线片上测量颈C2~3、C3~4、C4~5、C5~6、C6~7椎间隙的前缘、中点、后缘高度，椎间隙横径，椎间隙矢状径，螺钉进钉的最佳角度和深度，椎间盘角。分别计算各解剖参数的均值和标准差。 结果 纳入男性志愿者100人，平均年龄31.21岁，女性志愿者100人，平均年龄31.05岁。男性组椎间隙横径为（19.88±1.06）mm，矢状径（19.42±1.59）mm，前缘高度（5.57±0.74）mm，中点高度（7.24±0.98）mm，后缘高度（4.11±0.27）mm；上位螺钉进钉的最佳深度为（33.54±1.14）mm，下位螺钉进钉的最佳深度（24.35±1.53）mm；上位螺钉进钉的最佳角度为（41.10±2.86）°，下位螺钉进钉的最佳角度为（47.13±3.17）°；椎间盘角为（4.94±1.36）°。女性组椎间隙横径为（18.29±0.89）mm，矢状径（13.76±1.41）mm，前缘高度（5.12±0.64）mm，中点高度（6.68±0.67）mm，后缘高度（3.20±0.25）mm；上位螺钉进钉的最佳深度为（25.18±1.75）mm，下位螺钉进钉的最佳深度为（21.83±1.66）mm；上位螺钉进钉的最佳角度为（41.66±2.70）°，下位螺钉进钉的最佳角度为（47.03±2.43）°；椎间盘角为（4.80±1.38）°。男性组与女性组各参数对比，差异无统计学意义（P>0.05）。同节段椎间隙前、中、后缘高度均存在统计学差异，表现为后缘高度<前缘高度<中点高度（P<0.05）。 结论 通过正常人群颈椎X线解剖学测量，可获得设计零切迹颈椎椎间融合器的国人数据。
关键词：
; 颈椎; 椎间隙; 解剖学测量; 零切迹; 参数
Objective To provide a theoretical reference for designing the cervical anterior cervical zero-incision interbody fusion cage by measuring the anatomical parameters of the cervical intervertebral space of normal adults. Methods 200 healthy volunteers were included into doing X-ray, the following parameters were measured on X-ray of the cervical spine neutral lateral radiographs: leading edge, midpoint, posterior margin height of the C2/C3 to C6/C7 intervertebral space, transverse diameter of the intervertebral space, sagittal diameter of the intervertebral space, best angle and depth of the screw nail insertion, angle of the intervertebral disc. The mean and standard deviation of each anatomical parameter were calculated separately. Results The 100 male volunteers’ average age was 31.21 years old, while the 100 female was 31.05 years old. Parameters of the male group were as follows: the transverse diameter of intervertebral space was (19.88±1.06) mm, the sagittal diameter was (19.42±1.59) mm, the leading edge height was (5.57±0.74) mm, and the midpoint height was (7.24±0.98) mm, the height of the trailing edge was (4.11 ±0.27) mm, the optimal depth of the upper screw insertion was (33.54±1.14) mm, the optimal depth of the lower screw insertion was (24.35±1.53) mm. The optimal angle of the upper screw insertion was (41.10±2.86)°, the optimal angle of the lower screw insertion was (47.13±3.17)°, the angle of the intervertebral disc was (4.94±1.36)°. Parameters of the female group were as follows: the transverse diameter of the intervertebral space was (18.29±0.89) mm, the sagittal diameter was (13.76±1.41) mm, the leading edge height (5.12±0.64) mm, and the midpoint height (6.68±0.67) mm, the height of the trailing edge (3.20±0.25) mm, the optimum depth of the upper screw insertion was (25.18±1.75) mm, the optimal depth of the lower screw insertion was (21.83±1.66) mm, the optimal angle for the upper screw nail insertion was (41.66±2.70)°, the optimal angle for lower screw insertion was (47.03±2.43)°, the angle of intervertebral disc was (4.80±1.38)°. There were no significant differences in the above parameters between male and female groups (P>0.05). There were statistical differences in the heights of the anterior, middle and posterior margins of the intervertebral space at the same segment, which were characterized as follows: the height of the trailing edge < the height of the leading edge < the height of the midpoint (P<0.05). Conclusions We can get the data of adults for designing the cervical anterior cervical zero-incision interbody fusion cage by anatomical measurement of normal cervical vertebra X-ray
[1] Carrier CS, Bono CM, Lebl DR. Evidence-based analysis of adjacent segment degeneration and disease after ACDF: a systematic review[J]. Spine J, 2013, 13(10): 1370-1378.
[2] Barbagallo GM, Romano D, Certo F, et al. Zero-P: a new zero-profile cage-plate device for single and multilevel ACDF: a single institution series with four years maximum follow-up and review of the literature on zero-profile devices[J]. Eur Spine J, 2013, 22(Suppl 6): S868-S878.
[3] Cloward RB. The anterior approach for removal of ruptured cervical disks[J]. J Neurosurg, 1958, 15(6): 602-617.
[4] Smith GW, Robinson RA. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion[J]. J Bone Joint Surg Am, 1958, 40-A(3): 607-624.
[5] Park JB, Cho YS, Riew KD. Development of adjacent level ossification in patients with an anterior cervical plate[J]. J Bone Joint Surg Am, 2005, 87(3): 558-563.
[6] Hacker RJ. A randomized prospective study of an anterior cervical interbody fusion device with a minimum of 2 years of follow-up results[J]. J Neurosurg, 2000, 93(2 Suppl): 222-226.
[7] Wang Z, Jiang W, Li X, et al. The application of zero-profile anchored spacer in interior cervical discectomy and fusion[J]. Eur Spine J, 2015, 24(1): 148-154.
[8] Yang H, Chen D, Wang X, et a1. Zero–profile integrated plate and spacer device reduces rate of adjacent-level ossification development and dysphagia compared to ACDF with plating and cage system[J]. Arch Orthop Trauma Surg, 2015, 135(6): 78l -787.
[9] Hofstettr CP, Kesavabhotla K,Boockvar JA. Zero-profile anchored spacer reduces rate of dysphagia compared with ACDF with anterior plating[J]. J Spinal Disord Tech, 2015, 28(S): E284 -E290.
[10]Barbagallo GM, Romano D, Certo F, et al. Zero-P: a new zero-profile cage-plate device for single and multilevel ACDF: a single institution series with four years maximum follow-up and review of the literature on zero-profile devices[J]. Eur Spine J, 2013, 22(Suppl 6): S868-S878.
[11]刘锦波, 唐天驷, 杨惠林, 等. 中下颈椎体应用解剖测量及临床意义[J]. 中国临床解剖学杂志, 2001(1): 23-24.
[12]Theo HS, Ralph M, Martin VD, et al. Change in bone architecture during spinal fusion: three years follow-up and the role of cage stiffness[J]. Spine, 2003, 28(16): 1802-1809.
[13]Kansyama M, Hashimoto T, Shigenobu K, et al. Pitfalls of anterior cervical fusion using titanium mesh and local autograft[J]. Spinal Disord Tech, 2003, 16(6): 513-518.
[14]Cahill DW, Martin GJ Jr, Hajjar MV, et al. Suitability of bioresorbable cages for anterior cervical fusion[J]. J Neurosurg, 2003, 98(2 Suppl): 195-201.
[15]Choi SH, Lee H, Cho JH, et a1. Radiological parameters of undegenerated cervical vertebral segments in a Korean population[J]. Clin Orthop Surg, 2017, 9(1): 63-70.
[16]赵雄, 雷伟, 吴子祥, 等. 人工颈椎复合关节系统优化设计的解剖学参数测量[J]. 实用医学杂志, 2009, 25(11): 1785-1787.
[17] 谢兴国, 许仕全, 代小思, 等. 颈椎体间隙的应用解剖学研究[J]. 川北医学院学报, 2000, 15(4): 7-8.
[18]Lu J, Ebraheim NA, Yang H, et a1. Anatomic bases for anterior spinal surgery：surgical anatomy of the cervical vertebral body and disc space[J]. Surg Radiol Anat, 1999, 21(4): 235-239.
[19]王刚, 陈开润. 颈椎椎体间隙的应用解剖学[J]. 解剖学杂志, 2010, 33(3): 381-382.
京ICP备08002354号-3
