枢椎体前表面顶棒系统相关解剖学数据测量及临床意义

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摘要目的测量枢椎体前表面顶棒系统相关的解剖学数据，探讨其临床意义，为顶棒系统设计提供数据支撑。方法选取2013年1月至2016年12月在我院行颈椎CT三维重建的18岁以上患者100例，男性51例，女性49例，年龄28～85岁，平均(56.4±6.2)岁；身高150～178 cm，平均(161.7±6.6)cm。通过多平面重建技术(multiplanar reconstruction，MPR)和CT三维重建技术获得枢椎体三维立体图像及前表面图像。测量：A线枢椎体前表面双侧上关节突与枢椎体移行处之间距离；B线-A线中点与C线中点之间的距离；C线枢椎体前唇的宽度；D线-枢椎体前表面双侧凹陷顶点之间的距离；E线-D线到B线的垂直距离。比较男女之间、身高＞160 cm和身高≤160 cm对应的上述五组数据是否存在差异，并分析五组数据与性别、身高的相关性。结果 A线数据测量结果为(12.7±2.1)mm；B线数据(14.4±1.3)mm；C线数据(15.8±1.5)mm；D线数据(19.3±1.6)mm；E线数据(5.8±0.6)mm。男女之间比较、身高＞160 cm和身高≤160 cm之间比较，上述五组数据均存在显著统计学差异(P＜0.01)。上述五组数据与性别、身高之间存在明显相关性。结论 a)枢椎体前表面形态因身高和性别不同而存在明显差异；b)顶棒系统需依据枢椎体前表面解剖学数据设计出特有形态，才能增加与枢椎体前表面的适应性，以减少顶棒系统相关并发症。

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关键词 ：枢椎体前表面, 解剖学, CT三维重建, 顶棒系统

Abstract：Objective To measure the relevant anatomical data of the bucking bar syetem of the anterior surface of the axis and explore its clinical significance and provide data support for designing bucking bar system.Methods 100 patients aged 18 and older underwent CT 3D reconstruction of cervical spine in our hospital were enrolled in this study from January 2013 to December 2016.There were 51 males and 49 females.They were 28 to 85 years old，with the average age of (56.4±6.2).Their height was 150.0 cm to 178.0 cm，and the average height was (161.7±6.6)cm.Three-dimensional images and the anterior surface images of the axis were acquired through MPR and 3D reconstruction techniques.The following parameter were measured：A，The distance between bilateral superiorarticular process and the migration of the anterior surface of the axis；B，The distance between the midpoint of line A and midpoint of lineC；C，The width of the anterior lip of the axis；D，The distance between the vertex of the bilateral depression in the anterior surface of the axis；E，The vertical distance from line B to line D.Are there differences in the above five sets of data between males and females，the height is greater than 160cm and height is less than or equal to 160cm.At the same time，analyzing the correlation of the above five sets of data and gender，height.Results Line A：(12.7 ±2.1)mm；Line B：(14.4±1.3)mm；Line C：(15.8±1.5)mm；Line D：(19.3±1.6)mm；Line E：(5.8±0.6)mm.There were statistically significant differences in the above five sets of data between males and females，patients higher than 160cm and less than or equal to 160cm(P＜ 0.01)，and there were obvious correlation of the above five sets of data and gender，height.Conclusion a)There are obvious differencesin the anterior surface morphologyof the axis due to the height and gender.b)The bucking bar system should be designed according to the anatomical data of the anterior surface of the axis to increase the adaptability and to reduce the related complications.

Key words： anterior surface of axis anatomy three-dimensional CT reconstruction bucking bar system

作者简介: 张帅(1992－ )，男，研究生在读，西南医科大学附属医院脊柱外科，646000。

引用本文:

张帅，王清，段毅，王高举，杨进，徐双. 枢椎体前表面顶棒系统相关解剖学数据测量及临床意义[J]. 实用骨科杂志, 2018, 24(5): 418-422.
Zhang Shuai，Wang Qing，Duan Yi，et al. The Relevant Anatomical Data Measurement and Clinical Significance of the Bucking Bar System of the Anterior Surface of the Axis. sygkzz, 2018, 24(5): 418-422.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2018/V24/I5/418

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