上颈椎椎间旋转活动在体三维测量与分析

目的:探讨对人体上颈椎椎间旋转活动度及其耦合运动进行精确测量的方法。方法:对16名健康志愿者行颈椎三维CT扫描,并行三维重建,应用自行设计的计算机软件程序对三维图像标点,并利用标志点测量上颈椎包括枕骨与寰椎之间,寰椎与枢椎之间的椎间旋转及耦合运动。结果:颈椎最大旋转位时,单侧椎间平均旋转度分别为枕骨-寰椎(2.4±1.8)°,寰椎-枢椎(38.5±4.7)°,同时伴随各节段的反向侧屈与后伸活动;侧屈动度分别为枕骨-寰椎(3.6±1.3)°,寰椎-枢椎(5.4±2.0)°,后伸动度分别为枕骨-寰椎(12.9±3.8)°,寰椎-枢椎(4.9±2.6)°。结论:可运用三维CT图像对在体上颈椎椎间旋转及耦合运动进行精确的测量,其有助于上颈椎在三维空间内的复杂运动更进一步理解,更好地为上颈椎疾病的诊治提供解剖基础。

Three-dimensional measurement and analysis of the intervertebral rotation movement of the upper cervical spine in vivo

Objective To measure in vivo intervertebral coupled motions of the upper cervical spine. Methods Sixteen healthy volunteers underwent three-dimensional CT of the upper cervical spine. Relative motions between occiput (Oc) and atlas (C1) and between C, and axis (C2) were measured with the self-designed software analysis system. Results The mean maximum angles of axial rotation in Oc and C1 and C1 and C2 were (2.4±1.8)°and (38.54±4.7)° to each side, respectively.Coupled lateral bending with axial rotation was observed in the direction opposition to that of axial rotation in Oc and C1, meanly (3.64±1.3)°, and C1 and C2, meanly (5.4±2.0)°. Coupled extension with axial rotation occurred at both C0 to C1 , meanly (12.94±3.8)°, and C1 and C2, meanly (4.9±2.6)°. Conclusion The inter-vertebral coupled motions of the upper cervical spine in vivo are successfully measured with three-dimensional CT image. It will help us further understanding the complicated motions of the upper cervical spine, and will provide an anatomic basis for the treatment of the cervical spine disease.