中国组织工程研究

中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (33): 5356-5361.doi: 10.12307/2021.327

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

Micro-CT评估C2-C7关节突微结构区域特征及其结构功能稳定性

胡  哲1，赵海岩2，3，张少杰4，5，蔡永强5，王  星4，5，曲星月3，4，马  渊5，李志军4，5   

  1. 1包头医学院，内蒙古自治区包头市   014030；2通辽市医院影像科，内蒙古自治区通辽市   028000；内蒙古医科大学，3研究生学院，4基础医学院解剖学教研室，5数字医学中心，内蒙古自治区呼和浩特市   010059
  • 收稿日期:2020-12-11 修回日期:2020-12-17 接受日期:2021-01-30 出版日期:2021-11-28 发布日期:2021-08-06
  • 通讯作者: 李志军，教授，博士生导师，内蒙古医科大学基础医学院解剖学教研室，内蒙古自治区呼和浩特市 010059 马渊，副教授，内蒙古医科大学数字医学中心，内蒙古自治区呼和浩特市 010059
  • 作者简介:胡哲，男，1975年生，内蒙古自治区包头市人，汉族，2013年内蒙古医科大学毕业，硕士，副教授，主要从事脊柱数字化研究。 赵海岩，男，1980年生，内蒙古自治区通辽市人，汉族，2005年内蒙古医科大学毕业，硕士，副主任医师，主要从事影像诊断研究。
  • 基金资助:
    国家自然科学基金项目(81860383)，项目负责人：李志军

Evaluation of regional characteristics and structural, functional stability of C2-C7 articular process based on Micro-CT observation

Hu Zhe1, Zhao Haiyan2, 3, Zhang Shaojie4, 5, Cai Yongqiang5, Wang Xing4, 5, Qu Xingyue3, 4, Ma Yuan5, Li Zhijun4, 5   

  1. 1Baotou Medical College, Baotou 014030, Inner Mongolia Autonomous Region, China; 2Department of Imaging, Tongliao Hospital, Tongliao 028000, Inner Mongolia Autonomous Region, China; 3Graduate School, 4Department of Anatomy of Basic Medical College, 5Digital Medical Center, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China
  • Received:2020-12-11 Revised:2020-12-17 Accepted:2021-01-30 Online:2021-11-28 Published:2021-08-06
  • Contact: Li Zhijun, Professor, Doctoral supervisor, Department of Anatomy of Basic Medical College, and Digital Medical Center, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China Ma Yuan, Associate professor, Digital Medical Center, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China
  • About author:Hu Zhe, Master, Associate professor, Baotou Medical College, Baotou 014030, Inner Mongolia Autonomous Region, China Zhao Haiyan, Master, Associate chief physician, Department of Imaging, Tongliao Hospital, Tongliao 028000, Inner Mongolia Autonomous Region, China; Graduate School, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China
  • Supported by:
    the National Natural Science Foundation of China, No. 81860383 (to LZJ)

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摘要：

文题释义：
颈椎关节突：颈椎关节突关节是参与颈椎运动的重要结构，也是引起颈椎病、颈源性疾病的重要原因之一。
区域微结构：此次研究将关节突按应力方向分为上前、上后、下前、下后4个区域，计算各区域骨小梁的微观结构。
背景：颈椎关节突关节是参与颈椎运动的重要结构，也是引起颈椎病、颈源性疾病的重要原因，量化颈椎关节突骨小梁微结构的空间分布对于早期诊断骨骼疾病和潜在的骨折风险非常重要。
目的：确定颈椎关节突不同区域骨小梁微观形态学的空间分布特征，并研究骨小梁微体系结构区域差异对机械能力的影响，以评估颈椎的稳定性和安全性能。
方法：共144个颈椎关节突区域标本试样，每个关节被分为上前、上后、下前、下后4个感兴趣区域；Micro-CT扫描体积为5 mm×5 mm×5 mm试样，计算每个试样的微观结构，总结关节突区域微结构的变化规律，揭示其结构和受力优势及薄弱区域，评价颈椎安全稳定性能。
结果与结论：①关节突不同区域间骨小梁体积分数、骨表面积体积比、骨小梁分离度差异有显著性意义，偏Eta分别为5.5%，4.8%和4.3%(Eta%是变量相互影响的百分比，值越大，影响越大)，其中骨小梁体积分数值在关节突区域间差异最大；②C2-C7椎序间骨小梁体积分数、骨小梁数目、骨表面积体积比、骨小梁厚度、骨小梁分离度、骨小梁模块因子值差异有显著性意义，其中骨小梁数目的Eta最大，表明不同椎序间骨小梁数值差异最大；③左、右侧仅骨小梁厚度差异有显著性意义，偏Eta为2.0%，C2-C7骨小梁体积分数值左侧大于右侧关节突，最大区域均为上前区，最小区域均集中于C7；④骨小梁数最大值主要集中在上前、上后区域，而最小值集中在下后区域，C2-C5呈下降趋势，C5-C6则呈上升趋势，而C6-C7则显著下降；⑤骨表面积/骨体积总体变化趋势与小梁体积分数相反，主要集中区域最大在上后、最小在上前区域，符合该实验微观结构参数间变化特征；⑥C2 骨小梁厚度的左侧大于右侧，上后>上前>下前>下后的变化与小梁体积分数相似，最大区域集中在上前且C5关节突达到峰值，C2-C7左右两侧变化趋势相似；⑦骨小梁分离度最大和最小值集中在上后和上前区域(提示骨骼结构适合功能且具有明显的各向异性)；⑧骨小梁模块因子最大和最小值多集中于C7和C5；⑨C2-C7微结构和力学性能对其运动的贡献不同，与骨质量呈正相关的微结构参数小梁体积分数、骨小梁数、骨小梁厚度区域值越大，说明该区域骨质量越好，应力载荷能力越强，属于结构性能的优势区域不易发生损伤；反之亦然，与骨质量呈负相关的微结构参数骨表面积/骨体积、小梁分离度、骨小梁模块因子值越大，单位面积内骨小梁质量越差，其载荷应力能力也越弱，该区域发生损伤的风险将较高。
https://orcid.org/0000-0002-5269-883X (胡哲) ；https://orcid.org/0000-0001-5199-690X (赵海岩)

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: C2-C7, 关节突, 骨小梁, Micro-CT, 微观结构, 颈椎

Abstract: BACKGROUND: Cervical spine joints are important structures involved in cervical spine movements, and are also one of the important causes of cervical spondylosis and cervical-derived disease. Quantifying the spatial distribution of the trabecular structure of the cervical articular bone is very important for the early diagnosis of skeletal diseases and potential fracture risks.  
OBJECTIVE: To explore the difference of biomechanics between bone cement augmented and common proximal femoral nail antirotation in the treatment of type AO31-A3.3 intertrochanteric fracture.
METHODS:  A total of 144 specimens of cervical articular process. Each joint was divided into four regions of interest: superior anterior, superior posterior, inferior anterior, and posterior inferior. A sample with a volume of 5 mm×5 mm×5 mm was scanned by Micro-CT. The microstructure of each sample was calculated, and the characteristics of the microstructure changes in the articular process regions were summarized to reveal the structure and strength predominant areas and weak areas of the articular processes, and the safety and stability of the cervical spine were evaluated.  
RESULTS AND CONCLUSION: (1) There were significant differences in bone volume fraction (BV/TV), bone surface/bone volume (BS/BV), and trabecular separation (Tb.Sp) between different areas of the articular process. Partial Eta was 5.5%, 4.8% and 4.3%, respectively (Eta% is the percentage of variables influencing each other; the larger the value, the greater the influence). Among them, the BV/TV value had the largest difference between articular processes. (2) Significant differences were detected in C2-C7 vertebral sequence in BV/TV, trabecular number (Tb.N), BS/BV, trabecular thickness (Tb.Th), Tb.Sp, and trabecular bone pattern factor (Tb.Pf) values. Among them, the Eta of Tb.N was the largest, which indicated that the difference of Tb.N between different vertebral sequences was the largest. (3) There was a significant difference in Tb.Th between the left and right sides. The partial Eta was 2.0%. The left side of C2-C7 had a larger BV/TV value than the right articular process. The largest area was the superior anterior area, and the smallest area was concentrated in C7. (4) The maximum value of TB.N was mainly concentrated in the superior anterior and superior posterior areas, and the minimum value was concentrated in the posterior inferior area. C2-C5 declined; C5-C6 rose; and then C6-C7 dropped significantly. (5) The overall change trend of BS/BV was opposite to BV/TV. The maximum value was mainly concentrated in the superior posterior area, and the minimum value was mainly concentrated in the superior anterior area. (6) The left side C2 of Tb.Th was larger than the right side. The change of superior posterior > superior anterior > inferior anterior > posterior inferior was similar to that of BV/TV. The largest area was concentrated in the superior anterior area and the value of the C5 articular process peaked; and the changes on the left and right sides were similar. (7) The maximum and minimum values of Tb.Sp were mainly concentrated in the superior posterior and superior anterior regions (indicating that the bone structure was suitable for function and had obvious anisotropy). (8) The maximum and minimum values of Tb.Pf were mostly concentrated at the C7 and C5 levels. (9) The microstructure and mechanical properties of C2-C7 cervical vertebrae had different contributions to cervical vertebra motion. The larger the microstructure parameters BV/TV, Tb.N, and Tb.Th, which were positively related to bone mass, which meant the better the bone mass in this area, the better the stress load capacity; and it was less likely to be damaged because it belonged to the structural performance advantage area. Otherwise, the microstructure parameters BS/BV, Tb.Sp, and Tb.Pf, which were inversely related to bone mass, had larger values and the worse the load stress capacity, the higher the risk of damage in this area.

Key words: C2-C7, articular process, trabecular bone, Micro-CT, microstructure, cervical spine

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