摘要
背景:枕颈区不稳是由骨性或软组织结构异常或损伤造成的,而临床中患者枕颈区后方或前方上颈椎骨质破损时,需行经前路颅骨斜坡内固定,目前此手术方式多用于成人。迄今国内外尚无儿童在此区域的共性化置钉发育解剖数据(内固定钛板大小、位置等)作为参考。目的:研究1-6岁儿童斜坡及邻近解剖结构,为斜坡内固定钛板的放置提供详细资料。方法:将110名1-6岁儿童颈椎CT原始数据分为1-2岁组(n=30)、3-4岁组(n=39)、5-6岁组(n=41),运用Mimics软件行三维重建后测量颅外斜坡长、颅内斜坡长、斜坡底宽、咽结节距斜坡底距离等参数。结果与结论:①斜坡各参数指标的均值随年龄增长均呈上升趋势,3组间颅内外斜坡长、颅内外蝶枕软骨结合距斜坡底距离、斜坡底宽、咽结节距斜坡底距离、破裂孔内侧缘距离比较差异均有显著性意义(P<0.05),5-6岁组的斜坡顶宽与1-2岁组、3-4岁组比较差异有显著性意义(P<0.05),3组间斜坡颈椎角比较差异无显著性意义(P>0.05);②在斜坡放置内固定钛板的尺寸为:1-2岁组钛板顶端宽8 mm、中部宽19.1 mm、底端宽26.9 mm、长23.7 mm;3-4岁组钛板顶端宽8.1 mm、中部宽20.6 mm、底端宽31.3 mm、长26.5 mm;5-6岁组钛板顶端宽10.4 mm、中部宽22 mm、底端宽37.3 mm、长28 mm;③根据斜坡区参数分析得出1-6岁儿童各年龄段放置斜坡钛板的尺寸,并帮助临床医师掌握斜坡解剖结构,提高钛板放置安全性。
BACKGROUND:Occipital neck instability is caused by bone or soft tissue structural abnormalities or injuries.In clinical practice,patients with posterior or anterior upper cervical bone fractures in the occipital neck region need to undergo anterior skull slope internal fixation,which is currently used in adults.Up to now,there is no common developmental anatomy data(size and position of titanium plate for internal fixation)of children in this area at home and abroad for reference.OBJECTIVE:To study the slope and adjacent anatomical structures of children aged 1-6 years,and to provide detailed information for placement of titanium plates for internal fixation of slopes.METHODS:The original cervical CT data of 110 children aged 1-6 years were divided into three groups:1-2-year group(n=30),3-4-year group(n=39)and 5-6-year group(n=41).Mimics software was used for three-dimensional reconstruction to measure the parameters such as the length of the extracranial slope,the length of the intracranial slope,the width of the bottom of the slope,and the distance between the pharyngeal tuberculum and the bottom of the slope.RESULTS AND CONCLUSION:(1)The mean slope of each parameter was on the rise along with the age growth.Differences in intracranial slope length,intracranial external adjustment pillow cartilage combined with distance from the bottom of the slope,slope bottom width,pharynx nodules from the bottom of the slope distance,and broken hole inside edge distance were significant among the three groups(P<0.05).Slope top width was significantly different between 5-6-year group and the 1-2-year and 3-4-year groups(P<0.05).The slope angle of cervical spine was not significantly different among the three groups(P>0.05).(2)The dimensions of titanium plates for internal fixation placed on the slope were:the top width of titanium plate was 8 mm;the middle width was 19.1 mm;the bottom width was 26.9 mm;and the length was 23.7 mm in the 1-2-year group.The top width of titanium plate was 8.1 mm;the middle width was 20.6 mm;the
作者
李琨
李志军
张少杰
高尚
王星
孙昊
和雨洁
王海燕
蔡永强
徐雪彬
Li Kun;Li Zhijun;Zhang Shaojie;Gao Shang;Wang Xing;Sun Hao;He Yujie;Wang Haiyan;Cai Yongqiang;Xu Xuebin(Department of Human Anatomy,Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia;Digital Medical Center,Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia;Student Management Office,Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia)
出处
《中国组织工程研究》
CAS
北大核心
2021年第27期4289-4293,共5页
Chinese Journal of Tissue Engineering Research
基金
国家自然科学基金(81860382),项目负责人:王星
国家自然科学基金(81860383),项目负责人:李志军
国家自然科学基金(81660358),项目负责人:张少杰
内蒙古自治区研究生科研创新基金项目(S2018112010Z),项目负责人:李琨
内蒙古医科大学英才培育项目(YCPY20200090,YCPY20200002),项目负责人:李琨
内蒙古医科大学实验室开放项目(2020ZN48),项目负责人:李琨
内蒙古医科大学大学生创新创业项目(20201032001),项目负责人:李琨
内蒙古医科大学启蒙计划(FYQMJH2020034),项目负责人:李琨
内蒙古自然科学基金资助项目(2020MS03061),项目负责人:王星
内蒙古自然科学基金资助项目(2020LH08021),项目负责人:李志军
内蒙古自然科学基金资助项目(2019MS08017),项目负责人:张少杰。
关键词
儿童
枕寰枢复合体
斜坡
钛板
螺旋CT
发育特征
内固定
children
occipitoatlantoaxial complex
slope
titanium plate
spiral CT
developmental characteristics
internal fixation
