C7后路棘突螺钉固定的解剖可行性研究

Anatomic Study of the Posterior Spinous Process Screws Fixation on C7

目的:测量成人C7棘突螺钉固定的可行性和解剖参数,为临床应用提供参考。方法:取20具C7标本,仔细解剖以清楚地暴露椎板和棘突。用游标卡尺测量解剖学数据,包括C7棘突根部1/2、棘突中部、棘突后部1/2的高度,C7棘突根部头侧1/2、棘突根部中缘、棘突根部尾侧1/2的中点厚度,钉道长度、钉尖至椎动脉孔及脊髓的距离。随机抽取100名正常成年人CT图像测量C7棘突相关数据。结果:所有棘突螺钉均成功置入C7棘突。C7棘突平均高度和厚度分别为(11.25±2.28)mm、(12.53±3.11)mm。螺钉钉道长度平均为(9.83±2.23)mm,钉尖与椎动脉、脊髓的距离分别为(6.88±1.31)mm、(22.53±3.73)mm。下位螺钉钉道长度平均为(11.42±2.64)mm,明显长于上位螺钉钉道长度的(8.24±1.82)mm,差异有统计学意义(P<0.01)。100名正常成年人的C7棘突CT测量值与手工测量值比较差异无统计学意义(P>0.05)。结论:C7棘突螺钉具有解剖学可行性,有可能作为C7后路固定的一种补充内固定方法。

Objective：To measure the feasibility and the anatomic parameters in C7 spinous process screw fixation in adult bone specimen,and discuss the clinic significance.Methods： Twenty cervical cadaveric spines of C7 were dissected,with carefully taken to expose the lamina and spinous process, and measured digital caliper. Parameters measured manually included the height and width of spinous process, the spinous process screw trajectory and the distance between the tip of the screw and the vertebral artery and the spinal cord.The spinous process anatomic parameters of 100 patients CT scans of C7 were measured.Results：The C7 spinous process screws were successfully placed. The average height and width of the C7 spinous process were（11.25±2.28）mm and（12.53±3.11）mm,respectively.The spinous process screw trajectory and the distance between the tip of the screw and the vertebral artery and the spinal cord was（9.83±2.23）,（6.88±1.31）, and（22.53±3.73）mm. The average trajectory length of the superior spinous process screws was shorter than that of inferior spinous process screws,with a significant difference （P〈 0.01）. No statistical difference was seen between the data of C7 spinous process of 20 cadaver specimens obtained manually and 100 patients＇CT scans measurements individually（P〉0.05）.Conelusion：C7 spinous process screw fixation is feasible,which could be used as a supplementary method for conventional posterior screw fixation technique.