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颈椎后路重建的下颈椎侧块假体。

Subaxial Lateral Mass Prosthesis for Posterior Reconstruction of Cervical Spine.

机构信息

Department of Neurosurgery, Xuanwu Hospital, Beijing, China.

出版信息

J Neurol Surg A Cent Eur Neurosurg. 2023 Jul;84(4):316-320. doi: 10.1055/a-1739-2488. Epub 2022 Jan 13.


DOI:10.1055/a-1739-2488
PMID:35026858
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10226812/
Abstract

BACKGROUND: Posterior facetectomy or lateral mass resection is often used during cervical dumbbell tumor resection, jeopardizing the stability of cervical spine. The space after resection of one or more lateral masses, if left unfilled might hamper bone fusion and structural support. PURPOSE: There were the aims to obtain the relevant morphometry of the lateral mass of the subaxial cervical spine (C3-C7) and to design a lateral mass prosthesis for the posterior reconstruction of the cervical spine. METHODS: The computed tomography (CT) scans of healthy volunteers were obtained. RadiAnt DICOM Viewer software (Version 2020.1, Medixant, Poland) was used to measure the parameters of lateral mass, such as height, anteroposterior dimension (APD), mediolateral dimension (MLD), and facet joint angle. According to the parameters, a series of cervical lateral mass prostheses were designed. Cadaver experiment was conducted to demonstrate its feasibility. RESULTS: Twenty-three volunteers with an average age of 30.1 ± 7.1 years were enrolled in this study. The height of the lateral mass was 14.1 mm on average. The facet joint angle, APD, and MLD of the lateral mass averaged 40.1 degrees, 11.2 mm, and 12.2 mm, respectively. With these key data, a lateral mass prosthesis consisting of a column and a posterior fixation plate was designed. The column has a 4.0-mm radius, 41-degree surface angle, and adjustable height of 13, 15, or 17 mm. In the cadaver experiment, the column could function as a supporting structure between adjacent facets, and it would not violate the exiting nerve root or the vertebral artery. CONCLUSION: This study provided a detailed morphology of the lateral mass of the subaxial cervical spine. A series of subaxial cervical lateral mass prostheses were designed awaiting further clinical application.

摘要

背景:后路关节突切除或侧块切除常用于颈椎哑铃状肿瘤切除,这会危及颈椎的稳定性。切除一个或多个侧块后留下的空间,如果不填充,可能会妨碍骨融合和结构支撑。

目的:获得下颈椎(C3-C7)侧块的相关形态计量学数据,并设计一种侧块假体用于颈椎后路重建。

方法:获取健康志愿者的 CT 扫描。使用 RadiAnt DICOM Viewer 软件(版本 2020.1,Medixant,波兰)测量侧块的参数,如高度、前后径(APD)、内外径(MLD)和关节突关节角。根据这些参数,设计了一系列颈椎侧块假体。进行尸体实验以验证其可行性。

结果:本研究共纳入 23 名志愿者,平均年龄 30.1±7.1 岁。侧块的平均高度为 14.1mm。侧块的关节突关节角、APD 和 MLD 分别平均为 40.1 度、11.2mm 和 12.2mm。基于这些关键数据,设计了一种由柱体和后方固定钢板组成的侧块假体。柱体的半径为 4.0mm,表面角度为 41 度,高度可调节为 13、15 或 17mm。在尸体实验中,该柱体可作为相邻关节突之间的支撑结构,且不会侵犯现有神经根或椎动脉。

结论:本研究提供了下颈椎侧块的详细形态学数据。设计了一系列下颈椎侧块假体,等待进一步的临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3a/10226812/d2817d2b3e56/10-1055-a-1739-2488-i213241oa-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3a/10226812/41cb5eb8bf17/10-1055-a-1739-2488-i213241oa-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3a/10226812/9c82e3fd8366/10-1055-a-1739-2488-i213241oa-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3a/10226812/d2817d2b3e56/10-1055-a-1739-2488-i213241oa-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3a/10226812/41cb5eb8bf17/10-1055-a-1739-2488-i213241oa-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3a/10226812/9c82e3fd8366/10-1055-a-1739-2488-i213241oa-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b3a/10226812/d2817d2b3e56/10-1055-a-1739-2488-i213241oa-3.jpg

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Subaxial Lateral Mass Prosthesis for Posterior Reconstruction of Cervical Spine.

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引用本文的文献

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本文引用的文献

[1]
Posterior unilateral exposure and stability reconstruction with pedicle and lamina screw fixation for the cervical dumbbell tumorectomy: a case report and biomechanical study.

Eur Spine J. 2021-2

[2]
Cervical Facet Orientation Varies with Age in Children: An MRI Study.

J Bone Joint Surg Am. 2018-5-2

[3]
Computed Tomography- and Radiography-Based Morphometric Analysis of the Lateral Mass of the Subaxial Cervical Spine in the Indian Population.

Asian Spine J. 2018-2

[4]
Posterolateral fusion (PLF) versus transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis: a systematic review and meta-analysis.

Spine J. 2018-2-13

[5]
The Facet Orientation of the Subaxial Cervical Spine and the Implications for Cervical Movements and Clinical Conditions.

Spine (Phila Pa 1976). 2017-3-15

[6]
Fusion following lateral mass reconstruction in the cervical spine.

J Neurosurg Spine. 2015-2

[7]
An analysis of the anatomic features of the cervical spine using computed tomography to select safer screw insertion techniques.

Eur Spine J. 2013-11

[8]
Biomechanics of the spine. Part I: spinal stability.

Eur J Radiol. 2012-10-22

[9]
Outcome of posterior lumbar interbody fusion versus posterolateral fusion in lumbar degenerative disease.

J Clin Neurosci. 2011-4-19

[10]
Morphometric and volumetric analysis of the lateral masses of the lower cervical spine.

Spine (Phila Pa 1976). 2009-6-15

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