基于三维CT重建的寰椎椎弓根解剖学测量及临床意义

目的:研究螺旋CT三维重建测量人正常状态下寰椎椎弓根形态及其相关解剖学数据。方法:选取150例正常成人志愿者,年龄18~52岁(平均36.3岁),对其寰椎进行螺旋CT扫描,三维重建后观察椎弓根形态,并测量其双侧椎弓根各主要解剖数值:椎弓根高度、宽度、进钉点距后正中矢状面距离、椎根弓内倾角及上倾角。结果:根据椎弓根高度分为正常型,相对狭窄型,狭窄型,无椎弓根型。正常寰椎椎弓高度(4.10±1.17)mm,上倾角(8.24±1.31),°内倾角(6.53±2.35),°椎弓根宽度(8.24±1.31)mm,长度(28.73±1.66)mm,进钉点距后正中矢状面距离(19.36±1.27)mm。结论:三维CT重建能够全面观察寰椎影像解剖的立体结构,准确提供寰椎椎弓根的解剖学形态、解剖学参数,为寰椎椎弓根螺钉内固定技术提供解剖学依据。

Measurement of pedicles of atlas and axis by three-dimensional computer tomography and reconstruction and its clinical significance

Objective:To study the anatomic measurements of pedicles of atlas by 3D-CT reconstruction.Methods:150 normal atlas in adults from 18 to 52 years old(averaged age: 36.3 years old) were scanned by 3D-CT reconstruction,the anatomic measurements of both sides pedicles of atlas:height,width,length of pedicles,inside oblique angles,upslope angles of pedicles,distance from screw point of the pedicles to the median sagittal plane were measurd.Results:According to the thickness of bone substance of vertebral artery sulcus,the anatomical morphology of atlas pedicles were classified into four types: general(61.3%),relative stenosis(22%),stenosis(10%) and none pedicles(6.7%).The difference was not statistically significant.In normal atlas,the measurements of atlas were:Height of pedicles was(4.10±1.17)mm,width of pedicles was(7.66±0.84)mm,length of pedieles was(28.73±1.66)mm,inside oblique angles of pedicles was(6.53±2.35)°,upslope angles of pedicles was(8.24±1.31)°,distance from screw point of the pedicles to the median sagittal plane was(19.36±1.27)mm.Conclusion:The anatomic measurements of pedicles of atlas can be measured by 3D-CT reconstruction.And This supply the image anatomy evidence for atlas pedicle screw fixation.