前路齿状突中空螺钉导向仪的设计和解剖学研究

Anatomy study and design of the collimator for anterior cannulated odontoid screw

目的参照正常成年人颈椎的解剖学数据，设计出一种前路齿状突中空螺钉导向仪。方法对上颈椎64排螺旋CT、颈椎正侧位X片检查显示正常的60例成年人影像资料进行数据分析，分为男女两组，对两组进行t或t’检验。结果获得与导向仪相关的解剖学数据；64排CT与颈椎侧位X片测量C2／3椎间盘前缘高度分别为男性组（3．26±1．19）mm、女性组（2．54±0．83）mm与男性组（3．21±0．78）mm、女性组（3．21±0．90）mm，按性别分别行t检验，两者差异均无统计学意义（P〉0．05）；颈椎侧位X线片测量男性组与女性组的C5椎体前下缘中点对应皮肤至C2椎体前下缘中点的长度分别是（89．09±6．85）mm和（75．93±5．67）mm，两者差异有统计学意义（P〈0．05）。结论根据测量数据结果设计出用于前路齿状突中空螺钉内固定术的导向仪，此导向仪的设计与人的解剖生理结构符合，易于临床实际操作应用。

Objective To design and product a collimator for anterior cannulated odontoid screw by measuring the data of normal adult cervical spine from the images. Methods A total of 60 normal adults who received 64 row slice CT of the upper cervical spine and the X-Ray plain film of the cervical spine were chosen and divided into male and female groups. Statistical analysis was performed. Results The main anatomy parameters for the design of collimator were obtained. There was no significant difference in the disc height of the C2 and C3 anterior edge between 64 row slice CT [ male： （3.26 ± 1.19） mm, and female： （2. 54 ±0. 83） mm] and X-ray [male： （3.21 ±0. 78） mm, and female： （3.21 ±0. 90） mm] in the lateral cervical spine （ P 〉 0. 05 ）. There was statistically significant difference in the length of C5 anterior lower edge midpoint corresponding skin straight pointing to the C2 front bottom edge midpoint between two groups [ male ： （ 89. 09 ± 6. 85 ） mm, and female ： （75.93 ± 5.67 ） mm ]. Conclusion The collimator is designed for anterior cannulated odontoid screw. This collimator matching with human cervical anatomy is easier to be used in the clinical application.