寰枢椎椎弓根影像学测量及临床应用【临床医学专业论文设计】

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1、临床医学论文•寰枢椎椎弓根影像学测量及临床应用作者：贾卫斗，郑铁钢，杨博贵，白桂有，许英杰，云徳才【摘要】〔目的〕探讨利用影像学资料，测量寰枢椎椎弓根的数据，提高寰枢椎椎弓根置钉的成功率。〔方法〕对寰枢椎CR、DRX线片、MR1及64排CT片，通过图像储存传输系统，测量寰椎椎弓根进行进钉点、进钉角度的测量。〔结采〕寰椎椎弓根进钉点:左侧(19・93±l・32)mm，右侧(19.16±1・30)mm；寰椎椎弓根向内侧进钉角度:左侧23.72°±2.09°，右侧23・35°±1・91°；寰椎向头侧进

2、钉角度9°±1.2°°枢椎椎弓根进钉点:左侧(13.14±0.82)mm，右侧(13.85+0.79)mm；枢椎椎弓根向内侧进钉角度:左侧24.52°±1・26°，右侧20.42°±1.42°；枢椎向头侧进钉角度25°±3°。对48例患者行寰枢椎椎弓根经椎弓根内固定手术。其中男35例，女13例。年龄22〜61岁，平均43・60岁。II型陈旧性齿状突骨折22例，齿状突不连12例，横韧带损伤14例。所有患者X线片示寰椎完全复位，枢椎齿状突骨折处对位良好。平均10.6个月，均获得骨性融合。按JOA评分

3、标准，优31例，良14例，可2例，差1例，优良率93.75%。〔结论〕利用影像学资料测量，对寰枢椎椎弓根内固定手术的实际操作有良好的指导意义。【关键词】寰枢椎；椎弓根；影像学资料；测量；内固定Abstract:[Objective]Toprovidequantitativedataofatlantoaxialpedicleforitssurgicalscrewinternalfixationbyimageologymeasurementandimprovethesuccessrateofthes

4、urgicaltreatment・(Method]TheexaminationsofCR,DRX,MRIand64-rowCTwereperformedineachpatientprcopcrativcly,andtheatlantoaxialpediealscrewentrypointsandscrewentryangleswerethenmeasuredbyPACseesystem.[Result〕Theatlaspediclescrewentrypointswerelocalizedpos

5、itionwhichitsdistancetotheleftoftheatlaspediclemidiincwas(19.93±1.32)mm,andtotherightoftheatlaspediclemidiinewas(19.16±1・30)mm.Thescrewentryanglestotheinsideoftheatlaspediclewerelocalizedpositionwhichitsdistancetotheleftoftheatlaspediclemidlinewas(23

6、.72+2.09)°,andtotherightoftheatlaspediclemidiinewas(23.35±1.91)°.Thescrewentryangletotheheadoftheatlaspediclewas(9.00±1.20)°.Theaxispediclescrewentrypointswerelocalizedpositionwhichitsdistancetotheleftoftheaxispediclemidiinewas(13.14+0.82)mm,andtothe

7、rightoftheaxispediclemidiinewas(13.85士0.79)mm.Thescrewentryanglestoinsideoftheaxispediclewerelocalizedpositionwhichitsdistancetotheleftoftheaxispediclemidiincwas(24.52士1.26)',andtotherightoftheaxispediclemidiinewas(20.42±l.42)°,Thescrewentryangletoth

8、eheadoftheaxispediclewas(25±3)°.48patientsweretakentreatmentwithatlantoaxialpediclesurgicalscrewinternalfixation.Amongthesepatients,therewere35malesand13femaleswithameanage43.60yearsold(ranged22to61yearsold),22patientswithtype11oldodontoidfracture,12