CAJ | 학술논문

背景：对于儿童脊柱损伤的外科治疗适应证及治疗方式等尚存在争议。 　　目的：通过利用薄层CT影像资料并三维重建后测量，分析6-11周岁儿童腰椎椎弓根的形态、发育规律和增龄特征。 　　方法：选取无脊柱外伤、畸形及神经症状的6-11周岁儿童60例，行多排螺旋CT薄层扫描(0.625-1.25 mm)，范围为T12至 S1，将原始数据以 DICOM格式导入三维重建软件进行相关指标测量，并按不同节段进行统计分析。 　　结果与结论：①椎管横径与矢径随年龄和椎序增加呈递增趋势。②椎弓根宽和高随年龄的增加呈递增趋势，椎弓根宽随椎序的增加呈递增趋势，而椎弓根高则随椎序的增加则呈缓慢递减趋势，椎弓根高大于椎弓根宽。③钉道长随年龄的增加呈递增趋势，在腰椎处整体呈“波浪”型，且各椎间无显著性差异。④e 角随椎序的增加呈递增趋势，而f角则随椎序的增加则呈“波浪状”递减趋势。说明儿童腰椎椎管横径、矢径、椎弓根宽、高、钉道长、e角和f角与椎弓根螺钉置入有着密切的关系，临床应用中应根据儿童椎弓根的特征选取最佳的治疗方案。
배경：대우인동척주손상적외과치료괄응증급치료방식등상존재쟁의。 　　목적：통과이용박층CT영상자료병삼유중건후측량，분석6-11주세인동요추추궁근적형태、발육규률화증령특정。 　　방법：선취무척주외상、기형급신경증상적6-11주세인동60례，행다배라선CT박층소묘(0.625-1.25 mm)，범위위T12지 S1，장원시수거이 DICOM격식도입삼유중건연건진행상관지표측량，병안불동절단진행통계분석。 　　결과여결론：①추관횡경여시경수년령화추서증가정체증추세。②추궁근관화고수년령적증가정체증추세，추궁근관수추서적증가정체증추세，이추궁근고칙수추서적증가칙정완만체감추세，추궁근고대우추궁근관。③정도장수년령적증가정체증추세，재요추처정체정“파랑”형，차각추간무현저성차이。④e 각수추서적증가정체증추세，이f각칙수추서적증가칙정“파랑상”체감추세。설명인동요추추관횡경、시경、추궁근관、고、정도장、e각화f각여추궁근라정치입유착밀절적관계，림상응용중응근거인동추궁근적특정선취최가적치료방안。
BACKGROUND:Indications and therapeutic method of surgical treatment for Children’s spinal injury are stil controversial. OBJECTIVE:To analyze the morphology, development regularities and age characteristics of lumbar pedicle of children aged 6 to 11 years old by using thin layer CT image data and three dimensional reconstruction. METHODS:A total of 60 children at the age of 6 to 11 years without spine trauma, deformity and neurological symptoms were selected, and were scanned with multi-row spiral CT (0.625-1.25 mm) from T 12 to S 1 . The original data were imported into three-dimensional reconstruction software by DICOM format, and related index was measured. The data were statistical y analyzed according to different segments. RESULTS AND CONCLUSION: ①With increasing age and vertebral levels, transverse diameter and radius vector of the spinal canal had an increasing trend. ②With the increase of age, the pedicle width and height had an increasing trend. With the increase of vertebral levels, the pedicle width had an increasing trend, but pedicle height had a slowly decreasing trend. The pedicle height was greater than pedicle width. ③With the increase of age, the nail path length had an increasing trend. In the lumbar vertebra, nail path presented“waves”on the whole, and there was no significant difference between each vertebra. ④With the increase of vertebral levels, e angle had an increasing trend, but the f angle presented decreasing“wavy”trend. These results indicated that transverse diameter, radius vector, width and height of pedicle, nail path length, e angle and f angle were strongly associated with pedicle screw implantation. In clinical application, we should choose an optimal therapeutic method according to the features of pedicle of children.