Karaikovic E E, Daubs M D, Madsen R W, Gaines R W
Department of Orthopaedic Surgery, School of Medicine, University of Missouri-Columbia, Columbia, USA.
Spine (Phila Pa 1976). 1997 Mar 1;22(5):493-500. doi: 10.1097/00007632-199703010-00005.
Cervical pedicle morphology was investigated using manual and computed tomography measurements.
Normal anatomic variations of the cervical pedicles were measured to evaluate their safety as anchors for posterior cervical fixation systems.
There have been no cervical pedicle measurements on a large number of specimens. No study has ever measured the inner pedicle diameter.
Fifty-three spinal columns (C2-C7) of Euro-American origin identified by age, sex, and height (318 vertebrae or 636 pedicles) were measured using a digital caliper, a goniometer, and computed tomography scanning.
The pedicle axis lengths were similar from C3 to C7 (except for shorter C2 pedicles). In the horizontal plane, the medial inclination of the pedicles followed the cervical spinal cord enlargement. In the sagittal plane, the pedicles were directed superiorly in the upper spine and inferiorly in the lower cervical spine. Some pedicles had no medullary canal (i.e., were solid cortical bone: 0.9% C2, 2.8% C3 and C4, and 3.8% C5 pedicles). The outer pedicle width was smaller than the height in most of the pedicles. The inner pedicle width was equal to or smaller than 2 mm in 13.2% C2, 72.6% C3, 67.0% C4, 62.3% C5, 51.9% C6, and 16.0% C7. The outer pedicle width was equal to or smaller than 4 mm in 8.5% C2, 75.5% C3, 35.8% C4, 13.2% C5 and C6, and 6.6% C7 pedicles. The thinnest pedicle cortex was always the lateral cortex, which protects the vertebral artery. Measurements of the posterior pedicle projection also were taken.
These data provide anatomic limitations to pedicle screw use in the cervical spine.
采用手动测量和计算机断层扫描测量法对颈椎椎弓根形态进行研究。
测量颈椎椎弓根的正常解剖变异，以评估其作为颈椎后路固定系统锚钉的安全性。
此前尚未对大量标本进行过颈椎椎弓根测量。从未有研究测量过椎弓根内径。
使用数字卡尺、角度计和计算机断层扫描，对53个源自欧美的脊柱标本（C2 - C7）进行测量，这些标本按年龄、性别和身高进行了分类（共318个椎体或636个椎弓根）。
C3至C7的椎弓根轴长相似（C2椎弓根较短）。在水平面内，椎弓根的内侧倾斜度与颈髓增粗情况一致。在矢状面内，上颈椎的椎弓根向上，下颈椎的椎弓根向下。部分椎弓根无髓腔（即全为皮质骨：C2为0.9%，C3和C4为2.8%，C5为3.8%）。大多数椎弓根的外侧宽度小于高度。C2的13.2%、C3的72.6%、C4的67.0%、C5的62.3%、C6的51.9%和C7的16.0%的椎弓根内径等于或小于2毫米。C2的8.5%、C3的75.5%、C4的35.8%、C5和C6的13.2%以及C7的6.6%的椎弓根外侧宽度等于或小于4毫米。最薄的椎弓根皮质始终是外侧皮质，其保护椎动脉。还对椎弓根后凸进行了测量。
这些数据为颈椎椎弓根螺钉的使用提供了解剖学限制。
