摘要:
背景:近年来颈椎病的发生呈年轻化趋势,颈椎后路固定是治疗颈椎退变及损伤的主要方法,但缺乏青少年颈椎固定相关临床解剖学参数的测量数据.目的:三维数字化重建并测量12-14岁青少年颈椎C4-6椎骨后路固定解剖学参数.方法:随机选择2014年1月至2016年12月来内蒙古医科大学附属医院及内蒙古自治区乌兰察布市第二医院骨科就诊的21例12-14岁青少年人群颈椎C4-6椎骨CT扫描影像学资料,将资料导入 Mimics16.01软件进行三维重建并测量椎体前后及左右径,椎体前中后高,横突孔前后及左右径,钉道左右外偏角、上下偏角及钉道长.结果与结论:①解剖学参数:12-14岁青少年人群椎体及横突孔径线随着椎序的增加而增大,钉道的外偏角和上偏角同钉道长度一样,均随着椎序的增加而增大,颈椎 C4-6椎骨椎体移植骨块前后径应为6.0-8.0 mm,左右径应为25.0-30.0 mm,椎弓根钉外偏角应为29-35°,范围不应超过5°,椎弓根钉长度应在6.0-7.0 mm;②结果证实,实验采用三维数字化重建法成功获得了12-14岁青少年颈椎C4-6椎骨后路固定解剖学参数.%BACKGROUND: For recent decades, there has been a younger tendency in age of occurrence of the cervical spondylosis, and posterior fusion is the main method for cervical degeneration and injury, but no relevant fixation parameters are available in clinical practice for adolescents. OBJECTIVE: To measure the anatomical parameters of C4-6posterior fixation in the adolescents aged 12-14 years after three-dimensional reconstruction. METHODS: Twenty-one adolescents aged 12-14 years, who underwent cervical examination at the Affiliated Hospital of Inner Mongolia Medical University and Department of Orthopedics of the Second Hospital of Ulanqab between January 2014 and December 2016 were randomly selected, and the CT data of the C4-6were collected, and then imported into Mimics16.01 software for three-dimensional reconstruction. We measured the anteroposterior and transverse diameters and the heights of the vertebral body, anteroposterior and transverse diameters of the transverse foramina, angles of the left and right pedicle axes to sagittal and horizontal axes, and left and right pedicle axis lengths. RESULTS AND CONCLUSION: (1) Both anteroposterior and transverse diameters of the transverse foramina were increased with vertebral level incveasing. Both angles of pedicle axis to sagittal and horizontal axes, and pedicle axis lengths were increased with vertebral level. The anteroposterior diameter of the vertebral body at C4-6was in the range of 6.0-8.0 mm, the transversal diameter was in 25.0°-30.0°, the angle between the posterior screw and the horizontal axis was 29.0°-35.0°; in the sagittal plane, the angle to the sagittal axis was no more than 5°; and the pedicle screw path length was in 6-7 mm. (2) These results show the anatomical parameters of C4-6posterior fixation in the adolescents aged 12-14 years are successfully obtained by three-dimensional reconstruction.