CAJ | 학술논문

目的：探讨X线监视下颈椎前路经椎弓根植入螺钉的安全性。方法取南昌大学基础医学院解剖学教研室经10％中性甲醛浸泡的新鲜尸体标本10具，以标本下颈椎C3-7为研究对象，CT扫描、重建并测量双侧椎弓根最大宽度及高度，并在X线透视定位下经前路植入椎弓根螺钉，CT 扫描、三维重建分析螺钉位置，同时根据Tomasino 法评价植入螺钉的安全性。结果10具尸体标本中共测量100个椎弓根的高度及宽度，其中有6个椎弓根宽度＜4.0 mm和2个椎弓根高度＜4.0 mm而不能植入螺钉。经前路椎弓根植入螺钉92枚，其中横断位：Grade 178枚，Grade 213枚，Grade31枚；矢状位：Grade 187枚，Grade 23枚，Grade 32枚。结论在术前个体化的CT扫描、重建分析颈椎椎弓根形态的前提下，X线监视下经前路植入下颈椎椎弓根螺钉是安全的。
목적：탐토X선감시하경추전로경추궁근식입라정적안전성。방법취남창대학기출의학원해부학교연실경10％중성갑철침포적신선시체표본10구，이표본하경추C3-7위연구대상，CT소묘、중건병측량쌍측추궁근최대관도급고도，병재X선투시정위하경전로식입추궁근라정，CT 소묘、삼유중건분석라정위치，동시근거Tomasino 법평개식입라정적안전성。결과10구시체표본중공측량100개추궁근적고도급관도，기중유6개추궁근관도＜4.0 mm화2개추궁근고도＜4.0 mm이불능식입라정。경전로추궁근식입라정92매，기중횡단위：Grade 178매，Grade 213매，Grade31매；시상위：Grade 187매，Grade 23매，Grade 32매。결론재술전개체화적CT소묘、중건분석경추추궁근형태적전제하，X선감시하경전로식입하경추추궁근라정시안전적。
Objective To investigate the safety of anterior cervical transpedicular screw placement under X-ray monitoring. Methods Ten fresh adult cadaveric specimens preserved in the formaldehyde solution were obtained from Department of Anatomy of School of Basic Medical Sciences of Nanchang University. The bilateral cervical pedicle (C3-7) height and width for anterior transpedicular placement were measured by CT scan and reconstruction. Anterior cervical transpedicular screws were implanted into the cadaveric pedicles under X-ray monitoring. The position of screws was evaluated by CT and reconstructed images. The safety of screws was evaluated using Tomasino’s method. Results Of the 100 pedicles measured, 8 were too small to insert the screw (the width was less than 4.0 mm in 6 and the height was less than 4.0 mm in 2). Ninety-two screws were implanted successfully. In sectional plane, 78 screws were grade 1, 13 screws were grade 2 and 1 screw was grade 3. In sagittal plane, 87 screws were grade 1, 3 screws were grade 2 and 2 screws were grade 3. Conclusion The cervical anterior transpedicular screw under X-ray monitoring is safe under the premise of individualized preoperative CT scan and reconstruction analysis of cervical pedicle morphology.