螺旋CT对颈椎前路经椎弓根内固定安全性评估

中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (6): 658-660.

螺旋CT对颈椎前路经椎弓根内固定安全性评估

姜　建¹，　陈炤¹，　刘志礼¹，　尹庆水²，　舒　勇¹，　黄山虎¹

1.南昌大学第一附属医院, 南昌 330006;　2.广州军区广州总医院骨科医院, 广州 510010

收稿日期:2011-04-26 出版日期:2011-11-25 发布日期:2011-12-12
通讯作者: 刘志礼，副主任医师，Tel:13970072969，E-mail:zgm7977　@163.com E-mail:jij2002cn@yahoo.com.cn
作者简介:姜　建(1974-),男,江西贵溪人,硕士,主治医师,研究方向：脊柱影像，Tel:13576129759

The evaluation of spiral CT scans on the safety of cervical anterior transpedicular screw fixation

JIANG Jian¹, CHEN Zhao¹, LIU Zhi-li¹，YIN Qing-shui², SHU Yong¹, HUANG Shan-hu¹

1. The First Affiliated Hospital of Nanchang University, Nanchang 330006, China; 2. Orthopaedic Hospital, General Hospital of Guangzhou Military Command of PLA, Guangzhou 510010， China

Received:2011-04-26 Online:2011-11-25 Published:2011-12-12

摘要/Abstract

摘要：

目的探讨CT扫描在下颈椎前路经椎弓根螺钉安全植入中的意义。方法　取福尔马林浸泡尸体颈椎6具，16层螺旋CT扫描颈椎(C3~7)，三维重建测量前路经椎弓根固定相关解剖学参数，根据扫描参数结果选择植入螺钉椎弓根，C形臂X线机透视定位下经前路植入椎弓根钉，CT扫描三维重建分析螺钉位置(根据Tomasino 法评价植钉安全性)。结果　测量6具尸体颈椎(C3~7)，共60个椎弓根，其中有4个椎弓根宽度小于4.0 mm及1个椎弓根的进钉点太靠近椎体上终板而不能植入螺钉,经前路共植入椎弓根钉55枚。根据Tomasino 法评价：在横断位Grade1:52枚, Grade2:2枚, Grade3:1枚；在斜矢状位Grade1:52枚, Grade2:3枚。结论　术前个体化的CT扫描重建分析颈椎椎弓根形态为经前路颈椎椎弓根钉的安全植入提供保障。

关键词: 颈椎, 前路, 椎弓根螺钉, 椎体切除术, CT

Abstract:

Objective　To investigate the value of spiral CT on cervical anterior transpedicular screw insertion.　Methods　The cervical pedicle (C3~7) parameters for anterior transpedicular fixation from six cadaveric specimens were measured under CT scan and three dimensionally reconstructed. Cervical anterior transpedicular screws were implanted into cadaveric pedicles on the basis of the measured parameters. The position of cervical anterior transpedicular screws was evaluated by CT and reconstructing images, followed by the safety evaluation of screws insertion using Tomasino's method.　Results　In all of 60 pedicles (C3~7) measured, 4 was too small (the width of the pedicle<4.0 mm), and 1 was too closed to the upper plate, to be fixed. 55 screws were implanted successfully. Tomasino's evaluation demonstrated that, , Grade 1, 2 and 3 were 52, 2, and 1 screws in axial plane, and 52, 2, and 3 screws in saggital plane respectively.　Conclusions　Preoperative spiral CT scan is a valuable evaluation for safe insertion of cervical anterior transpedicular screw.

Key words: Cervical vetebrae, Anterior approach, Pedicle screw, Corpectomy, CT

中图分类号:

姜　建, 陈, 炤, 刘志礼, 尹庆水, 舒　勇, 黄山虎. 螺旋CT对颈椎前路经椎弓根内固定安全性评估[J]. 中国临床解剖学杂志, 2011, 29(6): 658-660.

JIANG 　Jian, CHEN , ZHAO , LIU Zhi-Li, YIN Qiang-Shui, SHU 　Yong, HUANG Shan-Hu. The evaluation of spiral CT scans on the safety of cervical anterior transpedicular screw fixation[J]. Chinese Journal Of Clinical Anatomy, 2011, 29(6): 658-660.

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