Lin Hua-Jie, Xu Rong-Ming, Liu Guan-Yi, Ma Wei-Hu, Sun Shao-Hua, Huang Liao-Yuan
Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China.
Zhongguo Gu Shang. 2012 Jul;25(7):594-8.
To measure anatomic data of spinous process and vertebral plate and evaluate the possibility of fixation of spinous process and vertebral plate.
Twenty cadaveric cervibal spines of C3-C7 were dissected to expose vertebral plate and spinous process, and were measured by two methods, one was manual measured using digital caliper and the other was computed tomography scaning. Parameters were measured manually including vertebral plate height and width. The screw was inserted from the boundary of the vertebral plate and spinous process, and gone out from the top of vertebral plate back of opposite side. Then through the CT reconstruction, angle of screw insertion, length of screw trajectory and distance between the screw tip and vertebral artery and spinal cord were measured. Additionally, spinous process width and vertebral plate thickness of 100 patients' CT scans of C3-C7 cervical segment were measured to evaluate possibility of screw insertion at spinous process and vertebral plate.
The screw fixation of lower cervical spinous process and vertebral plate were successfully placed,without impingement of spinal cord and vertebral artery. There was no statistic difference on the data of lamina height and width of 20 cadaver specimens between manual and CT measurements (P>0.05). Height and width of vertebral plate was (12.4 +/- 1.2) to (13.7 +/- 1.3) mm and (4.5 +/- 0.9) to (5.4 +/- 1.1) mm respectively and increased gradually from C3 to C7 (P<0.05). The trajectory length was (13.7 +/- 1.2) to (15.8 +/- 1.8) mm and increased gradually from C3 to C7 (P<0.05). The distance between screw tip and vertebral artery and spinal cord was (20.1 +/- 2.7) to (25.8 +/- 2.9) mm and (4.1 +/- 1.8) to (5.0 +/- 1.2) mm respectively. The angles of screws insertion were (73.0 +/- 9.9) degrees to (85.3 +/- 10.1) degrees in the axial plane (P>0.05). Based on the CT measurements of 100 patients,the data of the spinous process width and lamina thickness varied from a minimum of (8.5 +/- 1.1) mm and (4.3 +/- 0.5) mm for the C4, to a maximum of (14.5 +/- 2.0) mm and (6.0 +/- 1.1) mm for the C7 respectively.
Lower cervical spinous process and vertebral plate screw fixation is feasible, which is a safe and stable screw approach for spinous process and vertebral plate fixation.
测量棘突和椎板的解剖学数据，并评估棘突和椎板固定的可能性。
解剖20例C3 - C7尸体颈椎，暴露椎板和棘突，采用两种方法进行测量，一种是使用数字卡尺手动测量，另一种是计算机断层扫描。手动测量的参数包括椎板高度和宽度。将螺钉从椎板和棘突的边界插入，从对侧椎板顶部穿出。然后通过CT重建，测量螺钉插入角度、螺钉轨迹长度以及螺钉尖端与椎动脉和脊髓的距离。此外，测量100例患者C3 - C7颈椎节段的CT扫描图像中的棘突宽度和椎板厚度，以评估在棘突和椎板处插入螺钉的可能性。
下颈椎棘突和椎板的螺钉固定成功置入，未对脊髓和椎动脉造成压迫。20例尸体标本的椎板高度和宽度数据，手动测量与CT测量之间无统计学差异（P>0.05）。椎板高度和宽度分别为（12.4±1.2）至（13.7±1.3）mm和（4.5±0.9）至（5.4±1.1）mm，从C3到C7逐渐增加（P<0.05）。轨迹长度为（13.7±1.2）至（15.8±1.8）mm，从C3到C7逐渐增加（P<0.05）。螺钉尖端与椎动脉和脊髓的距离分别为（20.1±2.7）至（25.8±2.9）mm和（4.1±1.8）至（5.0±1.2）mm。在轴向平面上，螺钉插入角度为（73.0±9.9）度至（85.3±10.1）度（P>0.05）。基于100例患者的CT测量，棘突宽度和椎板厚度数据分别从C4的最小值（8.5±1.1）mm和（4.3±0.5）mm到C7的最大值（14.5±2.0）mm和（6.0±1.1）mm不等。
下颈椎棘突和椎板螺钉固定是可行的，是一种用于棘突和椎板固定的安全稳定的螺钉置入方法。
