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目的:对寰椎进行剖面解剖和三维CT测量,为临床提供寰椎椎弓根螺钉技术的解剖学和三维CT参数。方法:采用游标卡尺和量角器测量30例60侧C1湿骨剖面标本,采用GE LightSpeed 16 Pro螺旋CT操作软件(ADW4.2)测量30例60侧30～50岁正常人的C1三维CT图片。结果:剖面解剖学和3D-CT的测量结果分别为:寰椎侧块宽度为(10.42±1.50)mm、(10.1±1.4)mm;侧块长度为(21.33±1.06)mm、(21.5±1.3)mm;侧块高度为(10.22±0.80)mm、(10.3±1.1)mm;椎弓根中点至侧块前缘的距离为(27.98±1.32)mm、(27.8±1.2)mm;中线至寰椎椎管外缘的距离为(13.81±1.36)mm、(14.5±1.1)mm;中线至寰椎椎弓根中点的距离为(18.02±1.64)mm、(18.6±1.1)mm;中线至寰椎横突孔内壁的距离为(22.06±1.90)mm、(22.1±1.7)mm;椎管外缘至横突孔内壁的距离为(8.22±1.62)mm、(7.6±1.4)mm;寰椎后弓最薄处的宽度为(9.60±1.44)mm、(9.7±1.3)mm;高度为(4.60±0.11)mm、(4.4±0.8)mm,其中17侧(18侧)的寰椎后弓最薄处高度<4mm,占28.3%(30%);寰椎侧块角为(24.6±1.1)°、(24.8±1.5)°。两者的各个参数均无显著差异(P>0.05)。结论:剖面解剖学和三维CT的寰椎测量一致,均可为骨科医师提供寰椎椎弓根螺钉技术的可行性、进针点、进针方向和进针深度,但三维CT可提供具体、个体化的依据。
OBJECTIVE: To dissect anatomic and three-dimensional CT images of atlas and to provide anatomic and three-dimensional computed tomography (CT) parameters for atlas pedicle screw technique. Methods: 30 cases of wet side C1 wet bone specimens were measured by vernier calipers and protractor. The C1 three-dimensional CT images of 30 60-year-old normal people aged 30-50 years were measured by GE LightSpeed 16 Pro spiral CT software (ADW4.2). Results: The results of section anatomy and 3D-CT were as follows: the lateral mass of atlas was (10.42 ± 1.50) mm and (10.1 ± 1.4) mm, the lateral mass was (21.33 ± 1.06) mm and (21.5 ± 1.3) ) mm. The height of lateral mass was (10.22 ± 0.80) mm and (10.3 ± 1.1) mm respectively. The distance from the midpoint of pedicle to the anterior edge of lateral mass was (27.98 ± 1.32) mm and (27.8 ± 1.2) mm respectively. The distance between the midline and the midline of the pedicle was (18.02 ± 1.64) mm and (18.6 ± 1.1) mm respectively. The mean distance between the midline and the vertebral pedicle of atlas was (13.81 ± 1.36) mm and (14.5 ± 1.1) mm respectively. (22.06 ± 1.90) mm and (22.1 ± 1.7) mm respectively. The distance from the outer edge of the canal to the inner wall of the transverse process was (8.22 ± 1.62) mm and (7.6 ± 1.4) mm, respectively. The width of the posterior atlas at the thinnest was (9.60 ± 1.44) mm and (9.7 ± 1.3) mm, and the height was (4.60 ± 0.11) mm and (4.4 ± 0.8) mm, The height of the posterior arch at the thinnest was <4mm, accounting for 28.3% (30%). The lateral mass of the atlas was (24.6 ± 1.1) ° and (24.8 ± 1.5) °. There was no significant difference between the two parameters (P> 0.05). CONCLUSIONS: Cross-sectional anatomy and three-dimensional computed tomography are consistent with atlas measurements, which may provide orthopedic surgeons with atlas pedicle screw technique feasibility, needle entry, needle approach and needle penetration. However, 3D CT can provide specific, Individual basis.