目的:通过影像学方法测量脊柱颈胸段前路内固定手术相关的重要参数,为脊柱颈胸段前路手术术前计划的制定以及钢板螺钉内固定物的设计提供参考。方法:自2012年6月至11月,随机选取120例正常成人颈椎MRI正中矢状面影像,男58例,女62例;年龄20~78岁,平均(48.3±13.7)岁。利用PACS系统工作站自带的测量工具,分别测量各个椎体的前、中、后高度和上、中、下矢状径以及各个不同节段的前高度和Cobb角。结果:脊柱颈胸段椎体从头侧向尾侧,前、中、后高度以及上、中、下矢状径逐渐增大(P〈0.01)。对单个椎体而言,后高度〉前高度〉中高度(P〈0.01),下矢状径〉上矢状径〉中矢状径(P〈0.01),上位椎体的下矢状径与下位椎体的上矢状径数值较接近。男性受试者脊柱颈胸段Cobb角为(7.61±3.85)°,女性受试者脊柱颈胸段Cobb角为(5.58±2.59)°。结论:在行脊柱颈胸段前路内固定时,建议上位椎体进钉点在椎体中下1/3,螺钉可稍向头侧倾斜,下位椎体的进钉点在椎体的中上1/3,螺钉可稍向尾侧倾斜,并可根据正常成人的Cobb角对钢板进行预弯。
Objective:To measure important parameters of anterior internal fixation for the cervicothoracic junction by using imaging measurement,and provide reference for cervicothoracic junction surgery and design of steel plate screw internal fixation. Methods:From June to November 2012,120 health people's median sagittal plane MRI of cervical spine were randomly collected. Of the 120 cases,there were 58 males and 62 females with an average age of 48.3±13.7 ,ranging the age of 20 to 78 years old. The anterior,middle and posterior height of vertebral,anterior,upper,medium and lower sagittal diameter, anterior height of different segments and Cobb angle were measured by measuring machine in the PACS system. Results:The anterior,middle and posterior height of vertebral,medium and lower sagittal diameter gradually increased from cranial to caudal of cervicothoracic junction(P0.01). For single vertebral,posterior anteriormiddle height(P0.01),lower uppermedium sagittal diameter (P0.01). The lower sagittal diameter of upper vertebral body was close to upper sagittal diameter of lower vertebral body. Cobb angle of male was (7.61±3.85)°,while female’s was (5.58±2.59)°. Conclusion:During the anterior internal fixation of cervicothoracic junction,it is suggested that the entry points of upper vertebral body should locate on the lower and middle 1 / 3 of vertebral body,and screws could slightly incline towards cranial,the entry points of lower vertebral body should locate on the upper and middle 1 / 3 of vertebral body,while screws could slightly incline towards caudal,also can be prebent according to Cobb angle of health.