CAJ | 학술논문

背景：颈椎前路手术虽入路解剖结构较为复杂，风险大，但能固定颈椎主要承重的前柱，固定较为稳定，复发率较低。由于该项技术较新，临床缺乏相关固定参数。 　　目的：对C4-C6前路固定参数进行测量，为该节段前路固定治疗的广泛开展提供参数参考。 　　方法：选取2009年1月至2012年12月进行颈椎检查C4-C6颈椎无病变的35例研究对象的CT影像学资料，男20例，女15例；年龄25-50岁，平均41.2岁。采用Mimics16.01软件对影像资料进行重建测量椎体前后径及左右径，椎体高，椎骨横突孔的前后径与左右径，左右两侧横突孔内侧缘之间距离，左右两侧椎弓根轴线与矢状轴和水平轴的夹角及长度。 　　结果与结论：椎体左右径C4-C6由(26.67±0.25) mm逐渐增长到(32.89±0.12) mm，椎体前后径C4-C6由(6.89±0.12) mm逐渐增长到(8.85±0.44) mm，不同节段间比较差异均有显著性意义(P<0.05)。椎体正中矢状面前、中、后缘高度从C4[前缘(7.99±0.51) mm，中高为(7.09±0.42) mm，后高为(7.76±0.49) mm]；到C6[前缘为(9.89±0.45) mm，中高为(8.42±0.75) mm，后高为(8.84±0.26)mm]，椎体间比较差异有显著性意义(P <0.05)。椎骨横突孔前后径和左右径均随椎序的增加而逐渐增加(P <0.05)。C4-C6左右两侧横突孔内侧缘距离由(25.10±0.45) mm逐渐增长到(28.89±0.56) mm，不同节段间比较差异均有显著性意义(P <0.05)。椎弓根轴线与矢状轴和水平轴的夹角及长度均随颈椎序数的增加逐渐增大，差异有显著性意义(P <0.05)。
배경：경추전로수술수입로해부결구교위복잡，풍험대，단능고정경추주요승중적전주，고정교위은정，복발솔교저。유우해항기술교신，림상결핍상관고정삼수。 　　목적：대C4-C6전로고정삼수진행측량，위해절단전로고정치료적엄범개전제공삼수삼고。 　　방법：선취2009년1월지2012년12월진행경추검사C4-C6경추무병변적35례연구대상적CT영상학자료，남20례，녀15례；년령25-50세，평균41.2세。채용Mimics16.01연건대영상자료진행중건측량추체전후경급좌우경，추체고，추골횡돌공적전후경여좌우경，좌우량측횡돌공내측연지간거리，좌우량측추궁근축선여시상축화수평축적협각급장도。 　　결과여결론：추체좌우경C4-C6유(26.67±0.25) mm축점증장도(32.89±0.12) mm，추체전후경C4-C6유(6.89±0.12) mm축점증장도(8.85±0.44) mm，불동절단간비교차이균유현저성의의(P<0.05)。추체정중시상면전、중、후연고도종C4[전연(7.99±0.51) mm，중고위(7.09±0.42) mm，후고위(7.76±0.49) mm]；도C6[전연위(9.89±0.45) mm，중고위(8.42±0.75) mm，후고위(8.84±0.26)mm]，추체간비교차이유현저성의의(P <0.05)。추골횡돌공전후경화좌우경균수추서적증가이축점증가(P <0.05)。C4-C6좌우량측횡돌공내측연거리유(25.10±0.45) mm축점증장도(28.89±0.56) mm，불동절단간비교차이균유현저성의의(P <0.05)。추궁근축선여시상축화수평축적협각급장도균수경추서수적증가축점증대，차이유현저성의의(P <0.05)。
BACKGROUND:Although anterior cervical surgery approach and anatomical structure were relatively complex, with big risk, it can stably fix cervical anterior column of the main load-bearing, and its relapse rate is relatively low. Because this technique is relatively new, there is lack of related fixation parameters in the clinic. OBJECTIVE: To measure fixed parameters of C4-C6 anterior approach and to provide references for extensive treatment of segmental anterior fixation. METHODS:CT imaging data of 35 patients without C4-C6 cervical lesions, who were examined from January 2009 to December 2012, were selected in this study. There were 20 males and 15 females at the age of 25-50 years old, averagely 41.2 years. The image data were rebuilt by Mimics16.01 software. Moreover, we measured vertebral anteroposterior and transverse diameters, vertebral height, anteroposterior and transverse diameters of vertebrae transverse foramen, the distance of medial borders of left and right transverse foramen, the angle and length of the left and right pedicle axis and sagittal and horizontal axes. RESULTS AND CONCLUSION: The vertebral transverse diameter of C4-C6 gradualy increased from (26.67±0.25) mm to (32.89±0.12) mm; anterior and posterior diameter of C4-C6 gradualy increased from (6.89±0.12) mm to (8.85±0.44) mm, showing significant differences between different segments (P < 0.05). In vertebral median sagittal plane, anterior, middle and posterior height from C4 [anterior (7.99±0.51) mm, middle (7.09±0.42) mm, posterior (7.76±0.49) mm], to C6 [anterior (9.89±0.45) mm, middle (8.42±0.75) mm, posterior (8.84±0.26) mm], showing significant difference among vertebral bodies (P < 0.05). Anteroposterior and transverse diameters of vertebrae transverse foramen gradualy increased with increased vertebral order (P < 0.05). The distance of medial borders of C4-C6 left and right transverse foramen gradualy increased from (25.10±0.45) mm to (28.89±0.56) mm, showing significant differences among different segments (P < 0.05). The angle and length of the left and right pedicle axis and sagittal and horizontal axes gradualy increased with increased vertebral order (P < 0.05).