寰枢椎椎弓根影像学测量及临床应用_临床医学论文.docVIP

寰枢椎椎弓根影像学测量及临床应用_临床医学论文 寰枢椎椎弓根影像学测量及临床应用_临床医学论文 作者：贾卫斗，郑铁钢，杨博贵，白桂有，许英杰，云德才 【摘要】 ［目的］探讨利用影像学资料，测量寰枢椎椎弓根的数据，提高寰枢椎椎弓根置钉的成功率。［方法］对寰枢椎CR、DR X线片、MRI及64排CT片，通过图像储存传输系统，测量寰椎椎弓根进行进钉点、进钉角度的测量。［结果］寰椎椎弓根进钉点：左侧(19.93±1.32)mm，右侧(19.16±1.30)mm；寰椎椎弓根向内侧进钉角度：左侧23.72°±2.09°，右侧23.35°±1.91°；寰椎向头侧进钉角度9°±1.2°。枢椎椎弓根进钉点：左侧(13.14±0.82)mm，右侧(13.85±0.79)mm；枢椎椎弓根向内侧进钉角度：左侧24.52°±1.26°，右侧20.42°±1.42°；枢椎向头侧进钉角度25°±3°。对48例患者行寰枢椎椎弓根经椎弓根内固定手术。其中男35例，女13例。年龄22～61岁，平均43.60岁。Ⅱ型陈旧性齿状突骨折22例，齿状突不连12例，横韧带损伤14例。所有患者X线片示寰椎完全复位，枢椎齿状突骨折处对位良好。平均10.6个月，均获得骨性融合。按JOA评分标准，优31例，良14例，可2例，差1例，优良率93.75％。［结论］利用影像学资料测量，对寰枢椎椎弓根内固定手术的实际操作有良好的指导意义。 【关键词】 寰枢椎； 椎弓根； 影像学资料； 测量； 内固定 Abstract：［Objective］To provide quantitative data of atlantoaxial pedicle for its surgical screw internal fixation by imageology measurement and improve the success rate of the surgical treatment. ［Method］The examinations ofCR, DRX, MRI and 64-row CT were performed in each patient preoperatively, and the atlantoaxial pedical screw entry points and screw entry angles were then measured by PACsee system.［Result］The atlas pedicle screw entry points were localized position which its distance to the left of the atlas pedicle midline was ( 19.93±1.32) mm, and to the right of the atlas pedicle midline was (19.16±1.30)mm. The screw entry angles to the inside of the atlas pedicle were localized position which its distance to the left of the atlas pedicle midline was (23.72±2.09)°, and to the right of the atlas pedicle midline was (23.35±1.91)°. The screw entry angle to the head of the atlas pedicle was (9.00±1.20)°. The axis pedicle screw entry points were localized position which its distance to the left of the axis pedicle midline was (13.14+0.82) mm, and to the right of the axis pedicle midline was (13.85±0.79)mm. The screw entry angles to inside of the axis pedicle were localized position which its distance to the left of the axis pedicle midline was (24.52±1.26)°, and to the right of the axis pedicle midline was (20.42±1.42)°,The screw entry angle to