颈椎斜位片在下颈椎椎弓根螺钉术的研究

Application of 55°cervical oblique films in low Cervical transpedicular screw fixation

目的通过C形臂X线机以不同角度拍摄的尸体颈椎样本的斜位片观测颈椎椎弓根。在此基础之上不同角度的颈椎斜位片上观察术前拟行下颈椎椎弓根钉植入的患者颈椎椎弓根影象学表现。在这两个观测的基础上找到颈椎椎弓根及螺钉植入的最佳斜位片角度。方法选用干燥的人颈椎（C3～7）标本在C形臂X线机辅助下通过透视不同的斜位角度（40°、45°、50°、55°、60°）观测椎弓根。同时在颈椎标本观测的基础上,对拟行颈椎椎弓根螺钉植入患者术前摄不同角度的颈椎斜位片（45°、50°、55°）观测颈椎椎弓根的显示。两次试验都是观测椎弓根的长度及对侧椎弓根在椎体上显影的位置（把椎体3等分）。结果通过测量发现55°颈椎双斜位片对椎弓根长度的显示及对侧椎弓根位置显示与其他角度斜位片相比有明显的统计学差异（P〈0.05）。结论55°双斜位片对术前颈椎椎弓根的判断及术中椎弓根钉植入准确性的判断是斜位片的最佳角度。

Objective To observe lower cervical pedicle and evaluate the accuracy of lower cervical transpedicular screw by different bilateral cervical oblique films, which were done in human dried cervical vertebra. On this base, patients who will be operated low Cervical transpedicular screw fixation take different bilateral cervical oblique films to lower cervical pedicle. To find the best angle of cervical oblique films. Methods Take different bilateral cervical oblique films（40°、45°、50°、55°、60°）on human dried cervical vetabra to observe cervical pedicle .On the base ,patients who will be operated low cervical transpedicular screw fixation take different bilateral cervical oblique films （45°、50°、55°）to lower cervical pedicle and location of opposjte pedicle were much higher than other cervical oblique films （P〈0.05）.Conclusion 55°bilater cervical oblique film is best to observe cervical pedicle and evaluate the accuracy of cervical transpedicular screw.