新型枢椎棘突椎板螺钉固定的影像解剖学测量研究

doi:10.13418/j.issn.1001-165x.2024.3.03

Abstract

Abstract: Objective　To explore the feasibility of the novel C2 spinous lamina screw by using anatomical measurements on CT images and digital three-dimensional reconstruction.　Methods　Cervical CT data from 120 adults (59 males and 61 females) were collected and imported into Mimics 21.0 software using Dicom format for slicing and data measurement, 3D reconstruction and simulated screw placement. The thickness of C2 lamina, the height of C2 lamina, the length of C2 lamina, the width of the spinous root, the length of the simulated screw trajectory, the angle of inversion of the screw, the angle of inclination of the screw head, and the angle between the lamina and the sagittal plane were measured. The feasibility of the novel C2 spinous lamina screw placement was analyzed.　Results　There was no statistical difference between the measured data on both sides (P>0.05). There were significant differences in the height, thickness, and length of the C2 lamina, as well as the width of the spinous process and the length of the screw path between males and females (P<0.05). There were no significant differences in the uptilt angle of the screw, the medial tilt angle of the screw, and angle between lamina and sagittal plane of screws between male and female (P>0.05). The screw path length of the novel C2 spinous lamina screw was (27.16±3.92) mm for males and (23.90±4.25) mm for females, the medial tilt angle of the screw was (61.88±6.93) °, and the uptilt angle of the screw was (28.26±5.95) °. The length of the screw path of the novel C2 spinous lamina screw was moderately positively correlated with the height of the lamina and the thickness of the lower part of the lamina, and strongly positively correlated with the thickness of the upper and middle lamina.　Conclusions The novel C2 spinous lamina screw is feasible in the study of imaging anatomy, and the results of CT measurement and computer simulation provide theoretical support for the subsequent biomechanical research and clinical application.

Key words: Atlantoaxial dislocation, 　The novel C2 spinous lamina screw, 　CT, 　Anatomy

CLC Number:

R323.1

Ma Rencai, Ma Xiangyang, Zou Xiaobao, Fu Suochao, Deng Chenfu, Chen Junlin, Chen Zexing. Imaging anatomical measurement study on the fixation of the novel C2 spinous lamina screw[J]. Chinese Journal of Clinical Anatomy, 2024, 42(3): 251-258.

References

[1] Yamazaki M, Okawa A, Furuya T, et al. Anomalous vertebral arteries in the extra- and intraosseous regions of the craniovertebral junction visualized by 3-dimensional computed tomographic angiography: analysis of 100 consecutive surgical cases and review of the literature[J]. Spine, 2012, 37(22): E1389-1397. DOI: 10.1097/BRS.0b013e31826a0c9f .
[2] Lehman RA, Dmitriev AE, Helgeson MD, et al. Salvage of c2 pedicle and pars screws using the intralaminar technique: a biomechanical analysis[J]. Spine, 2008, 33(9): 960-965. DOI: 10.1097/BRS.0b013e31816c915b.
[3] Dorward IG, Wright NM. Seven years of experience with c2 translaminar screw fixation: clinical series and review of the literature[J]. Neurosurgery, 2011, 68(6): 1491-1499; discussion 1499. DOI: 10.1227/NEU.0b013e318212a4d7.
[4] 马向阳, 邹小宝, 付索超, 等. 枢椎棘突椎板螺钉固定技术的建立与初步临床应用[J]. 中华骨与关节外科杂志, 2023, 16(5): 408-413. DOI: 10.3969/j.issn.2095-9958.2023.05.03.
[5] 曹正霖, 钟世镇, 徐达传. 寰枢椎的解剖学测量及其临床意义[J]. 中国临床解剖学杂志, 2000, (4): 299-301. DOI: 10.13418/j.issn.1001-165x.2000.04.004.
[6] Wang MY. Cervical crossing laminar screws: early clinical results and complications[J]. Neurosurgery, 2007, 61(5 Suppl 2): 311-315; discussion 315-316. DOI: 10.1227/01.neu.0000303987.49870.7b.
[7] Goel A, Kulkarni AG. Screw implantation in spinous process for occipitoaxial fixation[J]. J Clin Neurosci, 2004, 11(7): 735-737. DOI: 10.1016/j.jocn.2004.03.021.
[8] 刘观燚, 徐荣明, 马维虎, 等. 枢椎棘突螺钉与椎弓根螺钉固定的生物力学拔出力比较[J]. 中华创伤骨科杂志, 2012, 14(4): 3. DOI: 10.3760/cma.j.issn.1671-7600.2012.04.009.
[9] Su BW, Shimer AL, Chinthakunta S, et al. Comparison of fatigue strength of c2 pedicle screws, c2 pars screws, and a hybrid construct in c1-c2 fixation[J]. Spine,2014, 39(1): E12-E19. DOI:10.1097/BRS. 0000000000000063.
[10] 马向阳, 尹庆水, 刘景发, 等. C2/3经关节螺钉固定的临床应用解剖研究[J]. 中国矫形外科杂志, 2005, 13(8): 3. DOI: 10.3969/j.issn.1005-8478.2005.08.011.
[11] 周鑫, 马向阳, 杨进城, 等. 枢椎4层皮质骨椎弓根螺钉的影像学测量及置钉策略[J]. 中国临床解剖学杂志, 2016, 34(1): 53-58. DOI: 10.13418/j.issn.1001-165x.2016.01.015.
[12] 高延征, 高坤, 余正红, 等. “in-out-in”多皮质枢椎椎弓根螺钉在寰枢椎脱位或不稳后路手术中的应用[J]. 中国脊柱脊髓杂志, 2017, 27(1): 55-60. DOI: 10.3969/j.issn.1004-406X.2017.01.10.
[13] Guo AF, Zhou X, Guo X, et al. C2 partial transpedicular screw technique for atlantoaxial dislocation with high-riding vertebral artery: a technique note with case series[J]. Clin Neurol Neurosurg, 2021, 200: 106403. DOI: 10.1016/j.clineuro.2020.106403.
[14] 刘观燚, 徐荣明, 马维虎, 等. 枢椎棘突椎板螺钉固定技术及其解剖学研究[J]. 中华外科杂志, 2011, 49(2): 162-165. DOI: 10.3760/cma.j.issn.0529-5815.2011.02.014.
[15] 胡勇, 徐荣明, 马维虎, 等. 枢椎后路椎板螺钉固定技术的可行性研究[J]. 中国骨伤, 2008, (8): 581-584. DOI: 10.3969/j.issn.1003-0034. 2008.08.006.
[16] 刘新宇, 张凯, 郑燕平, 等. 枢椎椎板螺钉固定的解剖学与影像学测量比较[J]. 解剖学报, 2011,42(6): 810-814. DOI: 10.3969/j.issn. 0529-1356.2011.06.019.

Imaging anatomical measurement study on the fixation of the novel C2 spinous lamina screw

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