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目的:确定枢椎椎弓根的最狭窄部位并观察其内部结构特点,为临床应用提供解剖学参数。方法:32例经GE LightSpeed 16 Pro螺旋CT扫描的成人图像,扫描完成后行内插重建为层厚0.625mm、层距0.3mm,在ADW4.2软件上进行多平面重建处理。在椎弓根狭部复合体内倾中轴线做内倾纵向切面,于纵向切面上确定椎弓根上倾中轴线,沿该上倾中轴线做上倾斜向切面,在该上倾斜面上的最狭窄部作垂直切面即椎弓根的最狭窄部位。结果:如果不考虑上关节突皮质骨,典型椎弓狭部的皮质骨轮廓形状近似钩状,钩身为椎弓狭部的内侧壁,钩尖为椎弓狭部的外侧壁部分,髓腔形状多呈竖置的椭圆形,内侧壁厚度(2.4±0.53)mm明显大于外侧皮质骨厚度(1.2±0.76)mm,椎弓狭部上方骨皮质厚度(2.7±0.76)mm明显小于下方部骨皮质厚度(3.2±0.92)mm,P<0.01。结论:椎弓狭部中段的外侧皮质骨厚度呈菲薄样,经椎弓根狭部复合体螺钉的方向以偏内偏上的安全系数高;对于国人来讲,枢椎的椎弓根内固定螺钉直径多以3～3.5mm较为合适。
OBJECTIVE: To determine the narrowest point of the pedicle of the axis and to observe its internal structure and provide anatomic parameters for clinical application. METHODS: Thirty-two adult images scanned by GE LightSpeed 16 Pro spiral CT were interpolated and reconstructed to 0.625 mm slice thickness and 0.3 mm slice thickness. The multiplanar reconstruction was performed on ADW4.2 software. In the pedicle of the narrow axis of the composite inclinometer longitudinal incision to do longitudinal incision in the longitudinal section of the pedicle to determine the central axis of the incline along the incline to do the incline to the incline to the incline, For the vertical section that pedicle the narrowest part. Results: The cortical bone contour of the typical arch of the spine was similar to the hook shape without considering the superior cortical bone. The hook was the medial wall of the arch of the vertebral arch. The tip of the hook was the lateral wall of the arch of the vertebral arch. (2.4 ± 0.53) mm was significantly larger than that of the lateral cortical bone (1.2 ± 0.76) mm. The thickness of the cortical bone above the stenosis (2.7 ± 0.76) mm was significantly smaller than that of the lower part of the bone Cortical thickness (3.2 ± 0.92) mm, P <0.01. Conclusion: The thickness of the lateral cortical bone in the middle part of the spina bifida is a thin film, and the safety factor is high in the direction of the screw of the pedicle stenosis. For the Chinese, the pedicle screw fixation Screw diameter to 3 ~ 3.5mm more appropriate.