寰枢椎侧块关节面形态的影像解剖学研究

Radiological study on the anatomical morphology of atlantoaxial lateral mass articular surface

目的探究寰枢椎侧块关节面解剖形态的影像学参数,为临床寰枢椎侧块关节间融合器的设计提供支持。方法回顾性研究。选取2019年1月—2020年6月在宁波市第六医院行颈椎CT检查的100名成人健康体检者的影像资料,其中男57人、女43人,年龄26~61(40.9±6.4)岁。受检者均行C1~C7范围CT扫描及二维重建;采用图片存档及通信系统软件,在矢状面及冠状面上分别测量对比两侧寰枢椎侧块关节面的曲度、长度、椎间隙高度,观察寰枢椎侧块关节面的形状,关节面凹陷或凸起的顶点位置的分布情况。结果寰枢椎侧块矢状位、冠状位左右两侧关节面曲度、长度、椎间隙高度比较,差异均无统计学意义(P均值>0.05)。左右两侧数据合并后:寰、枢椎侧块矢状位关节面曲度分别为171.16°±6.21°、166.37°±8.50°,冠状位关节面曲度分别为159.83°±8.22°、167.22°±10.40°;矢状位关节面长度分别为(16.38±1.61)、(16.59±1.63)mm,冠状位关节面长度分别为(16.75±1.71)、(17.14±1.69)mm;矢状位关节面前、中、后椎间隙高度分别为(2.87±0.80)、(2.22±0.63)、(3.25±1.00)mm,冠状位关节面的内、中、外椎间隙高度分别为(1.94±0.74)、(3.39±0.57)、(1.64±0.62)mm。寰枢椎侧块矢状位关节面形状以双凸和凸平居多,冠状位关节面形状以双凹和凹平居多。寰枢椎侧块矢状位、冠状位关节面顶点在中1/3处的较多。结论设计寰枢椎侧块关节间融合器时,不仅要考虑关节面矢状位及冠状位的长度和椎间隙的高度,还应考虑关节面的曲度及顶点位置,使其设计更优化。

Objective To evaluate the radiological parameters of the anatomical morphology of atlantoaxial lateral mass articular surface and support the design of clinical atlantoaxial lateral mass fusion cage.Methods A retrospective study.From January 2019 to June 2020,100 healthy adults who underwent cervical CT examination in Ningbo No.6 Hospital were selected retrospectively,including 57 males and 43 females,aged 26-61 years with an average age of(40.9±6.4)years.Philips 64-slice multislice spiral CT was used to scan C1-C7 and reconstruct 2D images.The curvature,length,and height of intervertebral space were measured and compared in the sagittal and coronal planes.The shape of the atlantoaxial lateral mass articular surface and the distribution of the vertex position of the concave or convex vertices were observed.Results No significant differences were observed in the curvature,length,and height of the intervertebral space between the left and right sides in the sagittal and coronal planes of atlantoaxial lateral mass(all P values>0.05).The curvatures of the sagittal atlantoaxial lateral mass articular surface were 171.16°±6.21°and 166.37°±8.50°.The curvatures of the coronal were 159.83°±8.22°and 167.22°±10.40°.The lengths of the sagittal atlantoaxial lateral mass articular surface were(16.38±1.61)and(16.59±1.63)mm.The lengths of the coronal were(16.75±1.71)and(17.14±1.69)mm.The anterior,middle,and posterior intervertebral space heights of the sagittal atlantoaxial lateral mass articular were(2.87±0.80),(2.22±0.63),and(3.25±1.00)mm,respectively.The inside,middle,and outside intervertebral space heights of the coronal were(1.94±0.74),(3.39±0.57),and(1.64±0.62)mm,respectively.The sagittal articular surface shape of atlantoaxial lateral mass was mostly double convex and convex flat.The coronal was mostly double concave and concave flat.In the sagittal and coronal plane,the vertex of the atlantoaxial lateral mass were more in 1/3 of the center.Conclusions The curvature of the atlantoaxial lateral mass surface and the position of the vertex should be considered to optimize the shape of the cage.