Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
Catholic Institute for Applied Anatomy / Department of Anatomy, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
PLoS One. 2019 Jul 18;14(7):e0219119. doi: 10.1371/journal.pone.0219119. eCollection 2019.
Thus far, anatomical studies have reported data on the cervical pedicle, with the focus remaining on the pedicle itself. It was necessary to obtain more comprehensive data about the relationships between the lateral mass, pedicle, and transverse foramen for cervical pedicle screwing (CPS) and paravertebral foramen screwing (PVFS), a new technique. The purpose of this study was to describe the relationships between the lateral mass, pedicle, and transverse foramen. This study analyzed computed tomography images from 77 patients (42 female, 35 male; mean age: 63.95 years). The anatomical pedicle transverse angle (PTA) and linear parameters of the lateral mass were measured, and the relationship between the calculated angles and the anatomical PTA was investigated. θp was defined as the convergence angle from the posterolateral edge of the lateral mass to the pedicle, and θc was defined as the convergence angle from the posterolateral edge of the lateral mass to the anterolateral corner of the vertebral foramen. The thickness of the cortical bone of the medial wall of the lateral mass (cT) and the medial (mT) and lateral (lT) walls of the pedicle at C3-7 were also measured. The PTA was similar to θp and θc at C3-6, but different at C7. In all cases, the transverse foramen was located more anterior to the posterior wall of the cervical body at C3-6, but not at C7. mT and cT were significantly thicker than lT at all levels. Lateral fluoroscopic images show that when the probe is inserted along θc, it meets the counter corner of the lateral mass at C3-6 without invasion of the transverse foramen if it does not cross the posterior wall of the vertebral body. This can be significant when performing CPS and PVFS.
迄今为止，解剖学研究已经报道了颈椎椎弓根的数据，重点仍然是椎弓根本身。为了获得颈椎椎弓根螺钉固定术（CPS）和椎旁孔螺钉固定术（PVFS）等新技术所需的更全面的有关侧块、椎弓根和横突孔关系的数据，有必要对侧块、椎弓根和横突孔之间的关系进行描述。本研究分析了 77 例患者（42 例女性，35 例男性；平均年龄：63.95 岁）的 CT 图像。测量了解剖学椎弓根横角（PTA）和侧块的线性参数，并研究了计算角度与解剖学 PTA 之间的关系。θp 定义为从侧块的后外侧缘到椎弓根的收敛角，θc 定义为从侧块的后外侧缘到椎孔前外侧角的收敛角。还测量了侧块内侧壁皮质骨厚度（cT）和 C3-7 椎弓根的内侧壁（mT）和外侧壁（lT）的厚度。在 C3-6 水平，PTA 与θp 和θc 相似，但在 C7 水平不同。在所有情况下，横突孔在 C3-6 水平都位于颈椎体后壁的更前方，但在 C7 水平则不然。在所有水平，mT 和 cT 均显著厚于 lT。侧位透视图像显示，当探针沿θc 插入时，在 C3-6 水平，如果探针不穿过椎体后壁，探针会与侧块的对侧角相遇，而不会侵入横突孔。在进行 CPS 和 PVFS 时，这一点非常重要。
