摘要
目的:研究探讨下颈椎关节突关节前缘与椎体后缘的位置关系,为临床行下颈椎经关节螺钉植入时评价进钉深度提供参考。方法:选取无明显下颈椎畸形的标准颈椎侧位X线片100张,下颈椎标准CT平扫片50张,测量下颈椎关节突关节顶点、中部、基底部前缘与椎体后缘的距离(分别记为HS,HM,HI),椎体后缘之前为负、之后为正。并对测量数据行统计学分析。结果:所有关节突关节前缘距离、椎体后缘的距离从顶点到基底部逐渐减小(HS>HM>HI)。C3,4关节突关节前缘大多位于椎体后缘之前(HS,HM,HI均为负值);C4,5、C5,6关节突关节前缘逐渐后移;C6,7关节突关节前缘均位于椎体后缘之后(HS,HM,HI均为正值)。下颈椎关节突关节顶点前缘与椎体后缘的距离HS从C3,4到C6,7逐渐增大,C3,4为(0±0.25)mm,C4,5为(2.03±0.47)mm,C5,6为(2.45±0.56)mm,C6,7为(2.91±1.05)mm;下颈椎关节突关节中部前缘与椎体后缘的距离HM从C3,4到C6,7逐渐增大,C3,4为(-1.57±0.53)mm,C4,5为(0.50±0.26)mm,C5,6为(0.56±0.36)mm,C6,7为(1.54±0.39)mm;下颈椎关节突关节基底部前缘与椎体后缘的距离HI从C3,4到C6,7逐渐增大,C3,4为(-2.03±0.40)mm,C4,5为(0±0.30)mm,C5,6为(0.50±0.44)mm,C6,7为(1.08±0.70)mm。结论:在行下颈椎经关节螺钉固定时,螺钉的头部在C3,4应位于相应椎体后缘前方0～2mm,C4,5应位于相应椎体后缘之后0～2mm,C5,6应位于相应椎体后缘之后0.5～2.5mm,C6,7应位于相应椎体后缘之后1～3mm。下颈椎关节突关节前缘与椎体后缘关系的确立,可为临床工作中下颈椎经关节螺钉植入时判断进钉深度提供参考。
Objective：To explore the location of the anterior border of facets and the posterior border of vertebral bodies in lower cervical spine,and to provide a quantitative data to evaluate the correct length of transarticual screws in lower cervical spine during procedure. Methods：One hundred standard lateral X-ray films and fifty CT films on cervical spine were used to measure the distance of the anterior border of facets and the posterior border of vertebral bodies in lower cervical spine. HS, HM and HI were defined as parameters, which means the distance between the anterior border of the superior（HS）, median （HM） and infe- rior（HI ） part of facets and the posterior border of corresponding vertebral bodies. The value will be negative if the anterior bor- der of the facet located before the vertebral body. Results ： HS 〉 HM 〉 HI was found in all facets in lower cervical spine. The anterior border of the facet in C3.4 located before the posterior border of the vertebral body of C3. The anterior border of C4.5 and C5.6 was inclined to posterior. The anterior border of C6.7 located after the posterior border of the vertebral body of C6. The pat- tern of HS increased from C3.4 to C6.7, the minimal （0_±0.25） mm and the maximal （2.91 ± 1.05 ） mm. The tendency of HM raised from C3.4 to C6,7, the minimal （- 1.57±0.53 ） mm and the maximal （1.54_±0.39） mm. The pattern H1 added from C3.4 to C6.7, the minimal （-2.03±0.40） mm and the maximal （1.08 ±0.70） mm. Conclusion：During the implantation of the transarticular screws,the tip of the screws should be 0-2 mm before the posterior border of the vertebral body of C3 at C3.4,0-2 mm after that of C4 at C4.5,0.5-2.5 mm at C5.6 and 1-3 mm at C6.7. The quantitative location between the anterior border of facets and the pos- terior border of the corresponding vertebral bodies can offer an indirect method to evaluate the correct length of transarticual screws in lower cervical spine during procedure.
出处
《中国骨伤》
CAS
2008年第10期762-765,共4页
China Journal of Orthopaedics and Traumatology
关键词
下颈椎
椎关节突关节
内固定器
放射摄影影像解释
计算机辅助
Cervical vertebrae
Zygapophyseal joint
Internal fixators
Radiographic image interpretation,computerassisted
