School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
Human Anatomy Teaching and Research Section, School of Basic Medicine, Inner Mongolia Medical University, Hohhot, 010059, Inner Mongolia, China.
Sci Rep. 2023 Jul 31;13(1):12400. doi: 10.1038/s41598-023-39703-4.
We will use micro-computed tomography to scan 31 sets of the adult lower cervical vertebrae (155 vertebrae) to observe the morphological characteristics and direction of trabeculae in the lower cervical vertebrae by outlining and reconstructing the regions of interest and to calculate the variation laws of the microstructure in the regions of interest to reveal their structural characteristics and weak areas. As a result, the images showed that the trabeculae in the lower cervical pedicle near the medial and lateral cortices were relatively dense, and their bone plates were lamellar. There were cavities between the superior and inferior articular processes where the ossification centers had not been absorbed after ossified. The lamellar trabeculae in the vertebral plates near the cortical bones were only 1-2 layers, extended and transformed into rod-shaped trabeculae in a radial shape toward the medullary space. The lamellar trabeculae of the vertebral plate extend over the spinous process near the cortical bone. The statistical results of the trabeculae's morphological parameters showed significant differences in bone volume fraction values among the four parts (P < 0.05). There were substantial differences in BS/BV, except for no differences between the pedicle and the vertebral plate (P < 0.05). There was a significant difference in trabecular pattern factor values between the articular process, the spinous process, and the vertebral plate (P < 0.05) and a significant difference between the pedicle, the spinous process, and the vertebral plate (P < 0.05). There were no significant differences in trabecular bone thickness and trabecular space values among the four parts (P < 0.05). The anatomical microstructural perspective confirms that the optimal choice is internal fixation via the pedicle. If using pedicle screws, the nail tract needs to be placed into the spinous process to increase its holding power and resistance to extraction.
我们将使用微计算机断层扫描技术对 31 套成人下颈椎(155 个椎体)进行扫描,通过勾勒和重建感兴趣区域来观察下颈椎骨小梁的形态特征和方向,并计算感兴趣区域的微观结构变化规律,以揭示其结构特征和薄弱部位。结果显示,在下颈椎椎弓根靠近内外皮质的骨小梁较为密集,其骨板呈板层状,在上下关节突之间有未被吸收的骨化中心形成的空腔。靠近皮质的椎板内的板层状骨小梁仅有 1-2 层,向髓腔呈放射状延伸并转化为杆状骨小梁。靠近皮质的棘突处的椎板板层状骨小梁延伸。骨小梁形态学参数的统计结果表明,四个部位的骨体积分数值差异有统计学意义(P < 0.05)。BS/BV 除了椎弓根和椎板之间无差异外,其余均有显著差异(P < 0.05)。关节突、棘突和椎板之间的骨小梁模式因子值有显著差异(P < 0.05),椎弓根、棘突和椎板之间有显著差异(P < 0.05)。四个部位的骨小梁厚度和骨小梁间距值差异无统计学意义(P < 0.05)。从解剖学微观结构的角度来看,椎弓根内固定是最佳选择。如果使用椎弓根螺钉,钉道需要进入棘突以增加其把持力和抗拔出力。