【摘要】 目的探讨三维CT测量下颈椎椎弓根并利用其测量数据辅助行下颈椎椎弓根个体化置钉,判断其准确性。方法成人颈椎标本6例行三维CT扫描重建,在三维图像上定出椎弓根的轴线,并画出沿皮质骨内外、上下侧缘与轴线的平行线在侧块上的投影,此投影区域即为置钉的进钉点范围。测量此区域与上位颈椎下关节突下缘和侧块外缘的距离,以及测量椎弓根轴线在横断面上与正中线的夹角及矢状面与终板的夹角。利用上述测量数据在标本C3~C7椎弓根进行置钉。将置钉后的标本再进行常规CT扫描,判断置钉的准确性。结果利用上述方法,57个椎弓根行置钉术,86%(49个)完全在椎弓根内,14%(8个)穿孔。其中6个穿破横突孔,2例向椎弓根上外侧穿出。置钉准确性高于以往实验研究的结果。结论利用三维CT测量的数据辅助行下颈椎椎弓根置钉是安全的,其准确性高于传统方法,但仍有一定的穿孔率,说明术中探针的手感仍非常重要。更多还原

【Abstract】 Objective To assess the accuracy of cervical transpedicle screw fixation under the help of data from three_dimension CT measurement. Methods Three_dimension CT measurement were made on 6 adult cervical vertebras obtained from cadavers.The pedicle axis and its projection on the lateral side were drawn.The distance from the project ion area of the axis to the inferior margin of the inferior articular process of the cranial adjacent vertebras and to the lateral mass boundaries were determined.The angle of the transverse plane and s agittal plane was measured too.The specimen was then fixed at C₃～C₇ according to above result s.The accuracy of placement was assessed by postoperative CT scan. Results Fifty seven pedicles were instru mented.86% （49 cases） were entirely within the pedical.15% （8 cases） had a breach.Six of t he eight perforations violated the transverse foramen.Two perforated laterally. Conclusion The insertion of cervical transpedile screw placement is safe on the basis of three_dimension CT measurement, despite the perforation exists.The tactile feedback from the hands of a surgeon is still useful.更多还原