Liawrungrueang Wongthawat, Cholamjiak Watcharaporn, Sarasombath Peem
Department of Orthopaedics, School of Medicine, University of Phayao, Phayao 56000, Thailand.
Department of Mathematics, School of Science, University of Phayao, Phayao 56000, Thailand.
J Clin Med. 2025 Jan 3;14(1):243. doi: 10.3390/jcm14010243.
Injuries involving the Atlas (C1) and Axis (C2) vertebrae of the cervical spine present significant clinical challenges due to their complex anatomy and potential for severe neurological impairment. Traditional imaging methods often lack the detailed visualization required for precise surgical planning. This study aimed to develop high-resolution 3D models of the C1 and C2 vertebrae to perform a comprehensive morphometric analysis, identify gender differences, and assess bilateral symmetry to enhance surgical accuracy. A retrospective analysis was conducted using CT scans from 500 patients aged 18 and older from a single-center hospital. Three-dimensional models were generated using InVesalius 3.1 and visualized with Meshmixer. Morphometric measurements included screw placement angles, lamina length and height, bicortical diameters, and pedicle widths. Statistical analyses were conducted using SPSS, with the Student's -test applied for gender and bilateral comparisons. Significant gender differences were found in certain measurements, such as pedicle width (4.85 ± 0.90 mm in males vs. 4.60 ± 0.85 mm in females, = 0.048) and C2 lamina height (12.90 ± 1.40 mm in males vs. 12.40 ± 1.25 mm in females, = 0.033). Most measurements exhibited bilateral symmetry, supporting their applicability across genders. These results align with previous studies and highlight the importance of tailored surgical approaches. Three-dimensional models of the C1 and C2 provide comprehensive morphometric data that enhance preoperative planning and surgical precision. Integrating these models into clinical practice can reduce intraoperative risks and improve patient outcomes in cervical spine surgeries.
涉及颈椎第一颈椎(C1)和第二颈椎(C2)的损伤因其复杂的解剖结构和严重神经损伤的可能性而带来重大临床挑战。传统成像方法往往缺乏精确手术规划所需的详细可视化效果。本研究旨在开发C1和C2椎骨的高分辨率三维模型,以进行全面的形态计量分析、识别性别差异并评估双侧对称性,从而提高手术准确性。使用来自一家单中心医院的500名18岁及以上患者的CT扫描进行回顾性分析。使用InVesalius 3.1生成三维模型,并用Meshmixer进行可视化。形态计量测量包括螺钉置入角度、椎板长度和高度、双皮质直径和椎弓根宽度。使用SPSS进行统计分析,采用学生t检验进行性别和双侧比较。在某些测量中发现了显著的性别差异,如椎弓根宽度(男性为4.85±0.90毫米,女性为4.60±0.85毫米,P = 0.048)和C2椎板高度(男性为12.90±1.40毫米,女性为12.40±1.25毫米,P = 0.033)。大多数测量显示双侧对称,支持其在不同性别中的适用性。这些结果与先前的研究一致,并突出了量身定制手术方法的重要性。C1和C2的三维模型提供了全面的形态计量数据,增强了术前规划和手术精度。将这些模型整合到临床实践中可以降低颈椎手术中的术中风险并改善患者预后。