基于三维CT重建的寰椎椎弓根解剖学测量及临床意义

Measurement of pedicles of atlas and axis by three-dimensional computer tomography and reconstruction and its clinical significance

目的：研究螺旋CT三维重建测量人正常状态下寰椎椎弓根形态及其相关解剖学数据。方法：选取150例正常成人志愿者,年龄18-52岁（平均36.3岁）,对其寰椎进行螺旋CT扫描,三维重建后观察椎弓根形态,并测量其双侧椎弓根各主要解剖数值：椎弓根高度、宽度、进钉点距后正中矢状面距离、椎根弓内倾角及上倾角。结果：根据椎弓根高度分为正常型,相对狭窄型,狭窄型,无椎弓根型。正常寰椎椎弓高度（4.10±1.17）mm,上倾角（8.24±1.31）,°内倾角（6.53±2.35）,°椎弓根宽度（8.24±1.31）mm,长度（28.73±1.66）mm,进钉点距后正中矢状面距离（19.36±1.27）mm。结论：三维CT重建能够全面观察寰椎影像解剖的立体结构,准确提供寰椎椎弓根的解剖学形态、解剖学参数,为寰椎椎弓根螺钉内固定技术提供解剖学依据。

Objective：To study the anatomic measurements of pedicles of atlas by 3D-CT reconstruction.Methods：150 normal atlas in adults from 18 to 52 years old（averaged age： 36.3 years old） were scanned by 3D-CT reconstruction,the anatomic measurements of both sides pedicles of atlas：height,width,length of pedicles,inside oblique angles,upslope angles of pedicles,distance from screw point of the pedicles to the median sagittal plane were measurd.Results：According to the thickness of bone substance of vertebral artery sulcus,the anatomical morphology of atlas pedicles were classified into four types： general（61.3%）,relative stenosis（22%）,stenosis（10%） and none pedicles（6.7%）.The difference was not statistically significant.In normal atlas,the measurements of atlas were：Height of pedicles was（4.10±1.17）mm,width of pedicles was（7.66±0.84）mm,length of pedieles was（28.73±1.66）mm,inside oblique angles of pedicles was（6.53±2.35）°,upslope angles of pedicles was（8.24±1.31）°,distance from screw point of the pedicles to the median sagittal plane was（19.36±1.27）mm.Conclusion：The anatomic measurements of pedicles of atlas can be measured by 3D-CT reconstruction.And This supply the image anatomy evidence for atlas pedicle screw fixation.