中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (4): 669-672.doi: 10.3969/j.issn.1673-8225.2012.04.023

• 数字化骨科 digital orthopedics • 上一篇    下一篇

下颈椎椎弓根放射影像学观察可描述椎弓根个性化特点及置钉相关性★

郭晓东1，张建湘2   

  1. 1内蒙古自治区人民医院骨科，内蒙古自治区呼和浩特市  010017；   2安徽医科大学附属医院骨科，安徽省合肥市 230030 
     
  • 收稿日期:2011-11-01 修回日期:2011-12-06 出版日期:2012-01-22 发布日期:2014-04-04
  • 作者简介:郭晓东★，男，1970年生，山西省五台县人，汉族，2002年安徽医科大学附属医院骨科毕业，硕士，副主任医师，主要从事脊柱外科及创伤骨科方面研究。gxd70@yahoo.com.cn

Individual characteristics of the pedicle and correlation with insertion screws: Radiographic observation of the cervical pedicle 

Guo Xiao-dong1, Zhang Jian-xiang2   

  1. 1Department of Orthopedics, People’s Hospital of Inner Mongolia Autonomous Region, Hohhot  010017, Inner Mongolia Autonomous Region, China; 2Department of Orthopedics, Affiliated Hospital of Anhui Medical University, Hefei  230030, Anhui Province, China
  • Received:2011-11-01 Revised:2011-12-06 Online:2012-01-22 Published:2014-04-04
  • About author:Guo Xiao-dong★, Master, Associate chief physician, Department of Orthopedics, People’s Hospital of Inner Mongolia Autonomous Region, Hohhot 010017, Inner Mongolia Autonomous Region, China gxd70@yahoo.com.cn

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摘要：

背景：因颈椎椎弓根结构复杂以及形态变异大，术中个性化置钉需要简便、可靠的监测方法。
目的：通过放射影像学观察描述下颈椎椎弓根在X射线片上的影像特点，为在下颈椎椎弓根内安全置钉提供帮助，以减少并发症。
方法：制备10新鲜颈椎骨标本，以细钢丝缠绑在下颈椎椎弓根狭窄部，摄颈椎正、侧、斜位片，观察下颈椎椎弓根形态在不同投照位置中的变化。
结果与结论：X射线片中下颈椎椎弓根的正位片影像是椎体两侧倾斜的管状结构，椎弓根椭圆形截面的长轴向内倾斜。侧位片上椎弓根未被直接显示，仅为重叠在椎体后上壁的高密度影。斜位片清楚的显示了椎弓根狭窄部的4个侧壁及其截面形状。提示颈椎正、斜位片的椎弓根影像可以较好地反映下颈椎椎弓根的形态，对了解椎弓根个性化的特点及置钉有重要意义。

关键词: 椎弓根螺钉, 颈椎, 椎弓根, 放射影像学, 内固定, 置钉

Abstract:

BACKGROUND: On account of the great morphological variation and complex structure of cervical pedicles, so it is essential to get reliable and convenient monitor methods during individual screw insertion.
OBJECTIVE: To describe the imaging features of subaxial cervical pedicles on roentgenogram by radiological image observation, which providing the security for cervical pedicles insertion and reducing complications.
METHODS: Totally 10 fresh-bone cervical spine specimens were prepared and the isthmus of the pedicle were drawn tightly with radiopaque fine malleable wire. The images of the subaxial cervical pedicles were taken in posteroanterior (PA) and lateral, oblique positions, the morphology of the subaxial cervical pedicles were observed in different projection positions.
RESULTS AND CONCLUSION: Radiographs of subaxial cervical pedicles were inclined tubular structure on both sides of the vertebral in PA positions, the long axis of the pedicle elliptical cross section tilte inward. The pedicle image was not shown directly in lateral radiograph, it was only an intensive density area made by the overlapping pedicles on the posterior-superior wall of the vertebrate in lateral radiograph. Four lateral cortex border of the isthmus in the pedicle and the shape of the cervical pedicle were demonstrated clearly in the oblique radiograph. The PA and oblique images of the subaxial cervical pedicles can better reflect subaxial cervical pedicles morphology, it is very useful to grasp the feature of every pedicle and is essential in the individual transpedicular fixation.

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