国人颈椎 C2 椎板的解剖与影像学测量。
The anatomic and radiographic measurement of C2 lamina in Chinese population.
机构信息
Department of Orthopaedic Surgery, Qilu Hospital, Shandong University, 107# Wenhua Road, Jinan 250012, Shandong, People's Republic of China.
出版信息
Eur Spine J. 2011 Dec;20(12):2261-6. doi: 10.1007/s00586-011-1876-5. Epub 2011 Jun 14.
OBJECTIVE
In this study, we performed anatomic and computed tomography (CT) measurements of C2 lamina in Chinese people in order to provide the anatomic and radiographic data, and to verify the clinical applicability of trans-lamina screws to this population.
METHODS
The anatomic and radiographic measurement was conducted on two separate groups, group A and group B. In group A, a total of 96 human adult (male 51, female 45) cadaver spines were included. The minimal height (H1), thickness (T), length (L1) of C2 lamina, height of the root of lamina (H2), distance from the entry point to the lateral rim of lamina (L2) and to the lateral rim of lateral mass (L3) were bilaterally measured using high precision calipers. The spino-laminar angles (angle A) were also included. In group B, a total of 112 volunteers (male 58, female 54) without upper cervical abnormality were enrolled. Angle A, H1, T, L1, H2, L2 and L3 were bilaterally measured using plain X-rays and reconstruction CT. All measurements were taken at the thinnest part of the lamina in the axial and coronal plane.
RESULTS
All the measurements (except angle A) in males were significantly higher than those in females (P < 0.05). There was no significant difference in the values of bilateral laminae between group A and group B (P > 0.05). The thickness of 45% specimens was less than 6 mm. The length of lamina in all specimens was less than 2.5 cm, while only 5% of the specimens had a length of >3 cm from the entry point to the rim of lamina. The length from the entry point to the lateral rim of lateral mass was between 2.5 and 4.6 cm. In contrast, the length of only 5% specimens was longer than 4 cm.
CONCLUSIONS
The preoperative radiographic evaluation is very important to determine the suitable size of screws. The diameter of screws is mainly restricted by the thickness of C2 lamina. It is safe to use screws with a length of 2.5-3.0 cm for Chinese people. The radiographic measurement method we used is simple, accurate and reliable for preoperative measurement.
目的
本研究对中国人 C2 椎板进行解剖学和 CT 测量，旨在提供解剖学和影像学数据，并验证 Trans-Lamina 螺钉在该人群中的临床适用性。
方法
解剖学和影像学测量分别在两组（A 组和 B 组）中进行。在 A 组中，共纳入 96 例成人（男 51 例，女 45 例）尸体脊柱。使用高精度卡尺双侧测量 C2 椎板的最小高度（H1）、厚度（T）、长度（L1）、椎板根部高度（H2）、进钉点至椎板侧缘（L2）和横突侧缘（L3）的距离，并测量 Spino-Laminar 角（角 A）。在 B 组中，共纳入 112 例无颈椎上部异常的志愿者（男 58 例，女 54 例）。使用平片和重建 CT 双侧测量角 A、H1、T、L1、H2、L2 和 L3。所有测量均在矢状面和冠状面的椎板最薄处进行。
结果
男性的所有测量值（除角 A 外）均显著高于女性（P<0.05）。A 组和 B 组双侧椎板的测量值无统计学差异（P>0.05）。45%的标本厚度小于 6mm。所有标本的椎板长度均小于 2.5cm，而仅有 5%的标本从进钉点到椎板边缘的长度大于 3cm。从进钉点到横突侧缘的距离为 2.5-4.6cm。相比之下，只有 5%的标本长度大于 4cm。
结论
术前影像学评估对于确定合适的螺钉尺寸非常重要。螺钉的直径主要受 C2 椎板厚度的限制。对于中国人，使用长度为 2.5-3.0cm 的螺钉是安全的。我们使用的影像学测量方法简单、准确、可靠，可用于术前测量。
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