基于PACS下颈椎侧块钉道长度的影像学三维测量及影响因素分析

Three-dimensional imaging measurement and analysis of affecting factors for the length of lateral mass screw in lower cervical spine based on the PACS

目的基于影像归档和通信系统(PACS)测量下颈椎侧块钉道长度并分析其影响因素,为临床置钉提供指导。方法选取2016年12月至2017年12月因颈椎退变或外伤于中国人民解放军北部战区总医院行颈椎手术的100例患者,收集术前颈椎三维CT数据并上传至PACS,测量C3~C6侧块(LMS)钉道长度,根据身高、体质量、性别、年龄、病因及BMI等因素将其分组并进行比较分析。结果下颈椎C3~C6LMS平均钉道长度为(14.58±1.20)mm,与以往研究测量结果基本一致。男、女组LMS平均钉道长度分别为(14.81±1.17)mm、(14.00±0.28)mm,两者比较差异有统计学意义(P<0.05)。高体质量组和低体质量组LMS平均钉道长度分别为(14.84±0.17)mm、(14.30±0.17)mm,两者比较差异有统计学意义(P<0.05)。不同身高组、病因组、年龄组测量结果显示C3~C6部分节段差异有统计学意义(P<0.05)。不同BMI组LMS钉道长度接近,差异无统计学意义(P>0.05)。结论性别、体质量是LMS钉道长度的影响因素,身高、年龄、病因对部分节段LMS钉道长度有影响,可为临床侧块螺钉置钉提供指导。

Objective To measure the length of lateral mass screw(LMS)in lower cervical spine based on the PACS and analyze the affecting factors to provide guidance for clinical screw placement.Methods A total of 100 patients diagnosed with traumatic cervical spine injury or degenerative cervical diseases who underwent cervical spine surgery in general hospital of northern theater command of PLA from December 2016 to December 2017 were selected,and harvested all the data of preoperative patients′three-dimensional cervical CT scan and sent them to PACS.The length of LMS from C 3 to C 6 was gauged separately,then patients were divided into different groups by height,weight,gender,age,pathogenesis and BMI and the data from different groups were compared and analyzed.Results The mean length of LMS from C 3 to C 6 was(14.58±1.20)mm,which was consistent with researches before.The mean length of LMS in male and female respectively were(14.81±1.17)mm and(14.00±0.28)mm,the difference was significant(P<0.05).The mean length of group high and group low divided by weight separately were(14.84±0.17)mm and(14.30±0.17)mm,the difference was significant(P<0.05).However,the mean length of LMS among those different groups divided by height,age and pathogenesis were not different completely,but for the BMI group,there was no difference(P>0.05).Conclusion Gender and weight are affecting factors of length of LMS in subaxial cervical spine,and the length of segmental LMS is affected by height,age and pathogenesis,which can be instructive for the clinical screw placement of LMS.