激光扫描多平面动态测量下颈椎椎间高度退变后椎间孔的变化
杨睿, 黄霖, 李卫平, 唐勇, 王鹏, 宋斌, 陈铿, 殷德振, 沈慧勇
中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (5) : 527-531.
激光扫描多平面动态测量下颈椎椎间高度退变后椎间孔的变化
The changes of the intervertebral foramen following the degeneration of lower cervical spine intervertebral space evaluated by 3D laser scan and multiple planar dynamic measurement
目的 激光扫描三维重建后动态测量下颈椎椎间高度退变时相应节段椎间孔的变化，为临床诊治神经根型颈椎病提供新的思路和参考。 方法 选用6具新鲜成人尸体颈椎标本，以C5/6单节段脊柱功能单位（FSU）作为研究对象。椎间盘切除后将C5/6椎间高度置于基准高度状态，激光扫描仪扫描收集该状态下C5/6 FSU的空间关系信息，再对骨性单椎体进行全面扫描，在Geomagic Studio8.0软件中再现 C5/6基准状态，并模拟6种椎间高度退变模型，即C5椎向C6椎椎体面趋于平行移动基准高度的10%、 20%、30%、40%、50%和60%。多平面动态测量方法（MPDM）分别测量椎间孔容积、中间面积、内口以及外口面积。 结果 测量数据显示随着椎间高度持续的下降，椎间孔的容积和面积逐渐减小，当椎间高度丢失基准高度30%时，椎间孔中间面积首先开始与基准状态有显著性差异（P=0.003）。 结论 激光扫描三维重建原貌再现骨性表面，是获得精确测量数据的前提；动态测量的方法较为客观准确，是测量椎间孔的理想方法；测量发现在下颈椎骨性椎间孔随着椎间高度在下降而缩小，其中间面积首先发生显著缩小，提示此处容易发生狭窄而引起临床症状。
Objective To observe the changes of the intervertebral foramen following the degeneration of lower cervical spine intervertebral space evaluated by 3D laser scan and multiple planar dynamic measurement (MPDM). Methods Six cadaver specimens of cervical spine were used in this study. Preoperative disc space height was measured radiographically, and regarded the mean disc space height of C4/5 and C6/7 as the baseline height of C5/6. The spatial information of C5/6 FSU on the state of baseline height was collected by 3-D laser scanner. Single C5 and C6 without soft tissue were scanned overall. C5/6 FSU was reconstructed in Geomagic Studio 8.0 by splicing the spot and cloud image to simulate six heights（10%, 20%, 30%, 40%, 50% and 60%）degeneration of lower cervical spine . Intervertebral foramen volume, the middle area, internal and external aperture area were measured respectively on seven states above using MPDM. Results As space height losing, the intervertebral foramen volume and area decreased gradually. When space height lose 30% of baseline height, the middle area of the intervertebral foramen decreased significantly than baseline height state (P=0.003). Conclusions Using 3-D laser scanner, the highly dummy 3-D surface image of bone can be exhibited accurately. MPDM is objective, accurate and repeatable for evaluating intervertebral foramina. The middle area of intervertebral foramen decreased significantly compared to the baseline height state, especially at the lose of space height about 30% of baseline height, which is possible to induce corresponding clinical symptom.
激光扫描三维重建 / 多平面动态测量 / 下颈椎 / 椎间孔
3D laser scan reconstruction / Multiple planar dynamic measurement / Lower cervical spine / Intervertebral foramina
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