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下颈椎椎弓根轴线与椎板平面夹角的影像学测量及其临床意义

[Imaging measurement and clinical significance of the angle between the axis of pedicle and the plane of lamina in lower cervical vertebra].

作者信息

Lu Zhenghao, Zhou Jinghua, Wang Weiguo

机构信息

Department of Spinal Surgery, Affiliated Nanhua Hospital, South China University, Hengyang Hunan 421002, China.

Department of Radiology, Affiliated Nanhua Hospital, South China University, Hengyang Hunan 421002, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Nov 28;42(11):1280-1287. doi: 10.11817/j.issn.1672-7347.2017.11.007.

Abstract

To explore the imaging measurement and clinical significance of the angle between the axis of pedicle and the plane of lamina in lower cervical vertebra.
 Methods: Three dimensional reconstruction of CT scan was performed in 30 patients with cervical deformity, and the angle between the axis of pedicle and the plane of lamina was measured with the specific reconstructed CT image of C3-C7.
 Results: 1) The left and right transverse angle of C3-C7 between the axis of pedicle and the ipsilateral plane of lamina were 98.3°±6.3°, 98.0°±5.1°, 97.5°±6.9°, 95.1°±5.0°, 85.8°±5.4° and 96.7°±8.2°, 98.7°±7.1°, 97.8°±3.6°, 93.2°±6.2°, 86.8°±5.7°, respectively, which showed a gradual decreasing trend. Meanwhile the angle of C3-C6 was more than 90 degrees and C7 was less than 90 degrees. In addition to C6 with C3 and C7 with other segments, the rest of the differences between the sections was not statistically significant (all P>0.05). 2) The left and right transverse angle of C3-C7 between the axis of pedicle and the pedicle of vertebral arch of lamina were 0.2°±4.5°, 1.2°±7.2°, -0.8°±6.8°, -3.3°±5.4°, -14.7°±4.0° and -1.6°±5.4°, 1.9°±4.6°, -0.5°±6.0°, -4.6°±5.3°, -13.7°±3.4°, respectively, which showed a first increasing and then reducing trend. Meanwhile the angle of C4 was maximum angle. In addition to C6 with C3, C6 with C4, and C7 with other segments, the differences between the sections was not statistically significant (all P>0.05). 3) The left and right sagittal angle of C3-C7 between the axis of pedicle and the ipsilateral plane of lamina were 77.7°±7.6°, 77.0°±7.1°, 85.3°±8.4°, 94.1°±2.2°, 94.9°±3.8° and 78.5°±7.1°, 76.2°±6.2°, 86.4°±6.4°, 94.0°±2.7°, 95.6°±3.8°, respectively, which showed a gradual increasing trend. The angle of C3-C4 was less than 90 degrees. C5 showed large variation and C6-C7 was more than 90 degrees. In addition to C3 with C4 and C6 with C7, the differences between the sections was statistically significant (all P<0.05). There was no significant difference between the two sides of the above indexes (all P>0.05).
 Conclusion: In low cervical vertebra, there is a certain angle relationship between the axis of pedicle and the plane of lamina, which can provide reference for the clinical determination of angle of pedicle screw insertion.

摘要

探讨下颈椎椎弓根轴线与椎板平面夹角的影像学测量方法及其临床意义。方法:对30例颈椎畸形患者进行CT扫描三维重建,利用重建的C3 - C7特定CT图像测量椎弓根轴线与椎板平面的夹角。结果:1)C3 - C7椎弓根轴线与同侧椎板平面的左右横角分别为98.3°±6.3°、98.0°±5.1°、97.5°±6.9°、95.1°±5.0°、85.8°±5.4°和96.7°±8.2°、98.7°±7.1°、97.8°±3.6°、93.2°±6.2°、86.8°±5.7°,呈逐渐减小趋势。同时C3 - C6角度大于90度,C7小于90度。除C6与C3、C7与其他节段外,各节段间差异无统计学意义(均P>0.05)。2)C3 - C7椎弓根轴线与椎板椎弓根的左右横角分别为0.2°±4.5°、1.2°±7.2°、 - 0.8°±6.8°、 - 3.3°±5.4°、 - 14.7°±4.0°和 - 1.6°±5.4°、1.9°±4.6°、 - 0.5°±6.0°、 - 4.6°±5.3°、 - 13.7°±3.4°,呈先增大后减小趋势。同时C4角度最大。除C6与C3、C6与C4、C7与其他节段外,各节段间差异无统计学意义(均P>0.05)。3)C3 - C7椎弓根轴线与同侧椎板平面的左右矢状角分别为77.7°±7.6°、77.0°±7.1°、85.3°±8.4°、94.1°±2.2°、94.9°±3.8°和78.5°±7.1°、76.2°±6.2°、86.4°±6.4°、94.0°±2.7°、95.6°±3.8°,呈逐渐增大趋势。C3 - C4角度小于90度。C5变异较大,C6 - C7大于90度。除C3与C4、C6与C7外,各节段间差异有统计学意义(均P<0.05)。上述指标两侧比较差异无统计学意义(均P>0.05)。结论:在下颈椎,椎弓根轴线与椎板平面存在一定角度关系,可为临床确定椎弓根螺钉置入角度提供参考。

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