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ID:44003292
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时间:2019-10-17
《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】》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
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
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