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外科研究与新技术 ›› 2020, Vol. 9 ›› Issue (3): 173-176.doi: 10.3969/j.issn.2095-378X.2020.03.007

• 论著 • 上一篇    下一篇

寰枢椎椎弓根螺钉螺旋CT钉道测量的临床价值

徐耿填, 王德春, 陈基宇, 黄青, 庄怀铭, 洪全, 陈彬勇, 林懿辉   

  1. 揭阳市人民医院骨二科,广东 揭阳 522000
  • 收稿日期:2020-06-28 出版日期:2020-09-28 发布日期:2021-05-13
  • 作者简介:徐耿填(1983—),男,临床医学硕士,副主任医师,从事脊柱外科工作;电子信箱:Xugeng.tian@163.com
  • 基金资助:
    揭阳市科技局立项(2018wsy1026)

Clinical value of CT measurement of screw channels before atlantoaxial pedicle screw implantation

XU Gengtian, WANG Dechun, CHEN Jiyu, HUANG Qing, ZHUANG Huaiming, HONG Quan, CHEN Binyong, LIN Yihui   

  1. Department of Orthopaedics Surgery II, Jieyang People’s Hospital, Jieyang 522000, Guangdong, China
  • Received:2020-06-28 Online:2020-09-28 Published:2021-05-13

摘要: 目的 分析采用螺旋CT测量寰枢椎椎弓根螺钉钉道有关数据,对指导临床合准确置入弓根钉效果。方法 在本院影像中心数据库中选择100例病患颈椎CT数据作为研究资料,研究时间均在2017年5月—2019年5月之间,同时利用MPR技术对寰枢椎椎弓根钉钉道各项解剖学数据进行测量。对于需行手术治疗的患者,通过测量数据指导其椎弓根钉置入。比较男性与女性在寰椎、枢椎各项指标方面差异;观察病患手术时间、手术过程中出血量、一次置钉成功率以及住院时间。结果 男性与女性在寰椎L1、L2、L3、L4、L5、α角以及β角方面比较无显著差异(P>0.05)。男性与女性在枢椎L1、L2、L3、L4、γ角以及θ角方面比较无显著差异(P>0.05)。100例病患手术时间平均值是(110.98±10.07) min;手术出血量平均值是(162.37±11.28) mL;住院时间平均值是(14.79±1.27) d;一次性置钉成功率是98.39%。结论 通过使用螺旋CT可以获取准确的寰枢椎椎弓根螺钉钉道解剖数据,采用多平面重建技术,优化钉道选择平面,可提升一次性置钉成功率。

关键词: 测量, 钉道, 计算机断层扫描成像技术, 椎弓根螺钉, 寰枢椎

Abstract: Objective To analyze the data of atlantoaxial pedicle screw channel measured by spiral CT, so as to guide the clinical reasonable placement of pedicle screws. Methods From the database of the image center of our hospital, 100 patients’ cervical CT data from May 2017 to may 2019 were retrieved and used to measure the anatomical indicators of atlantoaxial pedicle screw channel by MPR. For patients who needed surgery, the measurement data were used to reasonably insert the pedicle screws. Comparisons were made in the indicators of atlas and axis between males and females, operation time, the amount of bleeding during operation, the success rate of one-time screw placement, and the length of hospital stay. Results There were no significant differences between males and females in the atlas L1, L2, L3, L4, L5, α angle, and β angle (P>0.05), and the axis L1, L2, L3, L4, γ angle, and θ angle (P>0.05) .The average operation time of the 100 patients was (110.98±10.07) min, the average bleeding volume was (162.37±11.28) mL, the average hospitalization time was (14.79±1.27) d, and the success rate of one-time screw placement was 98.39%. Conclusion Applying spiral CT to obtain accurate anatomical data of atlantoaxial pedicle screw channel, in combination with multi-plane reconstruction technology to optimize screw channel selection plane, can improve the success rate of one-time screw placement.

Key words: Measurement, Screw channel, Computed tomography, Pedicle screw, Atlantoaxial

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