3~6岁儿童寰枢椎椎弓根在3D打印技术下的测量研究

Measurement of atlantoaxial pedicle of 3-6-year-old children by 3D printing technology

目的通过利用3D打印成像技术对3~6岁学龄前期儿童寰枢椎椎弓根进行数据测量,为学龄前期患儿置入寰枢椎椎弓根螺钉提供相关理论依据。方法收集河北省儿童医院行寰枢椎CT扫描的40例3~6岁儿童影像资料,排除寰枢椎骨折、畸形、肿瘤及感染性疾病等。选取其中40例寰枢椎CT影像资料,将患儿CT扫描数据通过3D Slicer软件重建出寰枢椎3D模型后测量椎弓根长、宽、高、宽高比值等数据参数。并将测量出数据按年龄分组,即A组(3~<4岁)10例、B组(4~<5岁)10例、C组(5~<6岁)10例、D组(6~<7岁)10例,男女比例均为1∶1。并对测量出数据进行统计学分析。结果同一年龄阶段寰枢椎左右侧别和男女比较差异并无统计学意义(P>0.05)。寰枢椎椎弓根长度、宽度以及高度测量指标均随年龄增长呈递增趋势,差异有统计学意义(P<0.05)。学龄前期寰椎侧块宽度/高度比值均>1.0,表示寰椎椎弓根宽度大于高度,并且随年龄增长比值无明显变化。学龄前期枢椎椎弓根宽度/高度比值均<1.0,表示枢椎椎弓根宽度小于高度,但随年龄增长比值无明显变化。结论采用等比例3D打印模型可获得小儿寰枢椎椎弓根实际准确数据。根据其测量数据表明,学龄前期儿童寰枢椎椎弓根可容纳最小3.5 mm直径椎弓根螺钉置入,故学龄前期儿童寰枢椎疾病可行最小3.5 mm直径的椎弓根螺钉固定,但年龄不同螺钉置入方式也有相应调整。

Objective To measure the atlantoaxial pedicles of 3-6-year-old preschool children by using 3D printing imaging technology,and to provide relevant the oretical basis for the placement of atlantoaxial pedicle screws in preschool children.Methods The imaging data of 40 children aged 3-6 years who underwent atlantoaxial CT scans in Hebei Children′s Hospital were collected,and atlantoaxial fractures,deformities,tumors and infectious diseases were excluded.A total of 40 cases of atlantoaxial CT imaging data were collected.The 3D model of atlantoaxis was reconstructed by 3D slicer software,and the data parameters such as pedicle length,width,height,width to height ratio were measured.The measured data were grouped by age,namely,group A(aged 3-<4 years,n=10),group B(aged 4-<5 years,n=10),group C(aged 5-<6 years,n=10),and group D(aged 6-<7 years,n=10),and the male to female ratio was 1∶1.The measured data were statistically analyzed.Results There was no statistical difference between the left and right sides of the atlantoaxial spine and between men and women in the same age group(P>0.05).Atlantoaxial pedicle length,width and height measurement indexes showed an increasing trend with age,and the difference was statistically significant(P<0.05).The ratio of the width/height of the lateral mass of the atlas in the preschool age was greater than 1.0,indicating that the width of the atlas pedicle was greater than the height,and the ratio did not change significantly with age.The ratio of the width/height of the axis pedicle in the preschool age was less than 1.0,indicating that the width of the axis pedicle was less than the height,but the ratio did not change significantly with age.Conclusion The actual and accurate data of the atlantoaxial pedicle of children can be obtained by using the isometric 3D printing model.According to its measurement data,the atlantoaxial pedicle of preschool children can accommodate a pedicle screw with a minimum diameter of 3.5 mm.Therefore,atlantoaxial disease of preschool children can be fixed with a pedicle screw with a minimum diameter of 3.5 mm,but different screw placement methods are also recommended according to the age.