寰椎椎弓根螺钉置入Axis M钉道进钉点与椎动脉相互关系的CTA研究

CTA study of the relationship between insertion point of C_(1) transpedicular screw insertion trajectory Axis M and vertebral artery

目的研究寰椎椎弓根Axis M钉道进钉点与椎动脉V_(3)段的空间位置关系。方法采用后处理工作站对影像存档与传输系统内60例头颈部CT血管造影患者进行回顾性重建,测量以下参数:A.Axis M钉道进钉点对应C_(1)后弓上缘皮质与椎动脉的距离。B.Axis M钉道进钉点对应C_(1)后弓上缘皮质与椎动脉和寰椎椎动脉沟外缘交界处的距离。C.Axis M钉道进钉点与寰椎横突孔外层皮质的最短距离。D.Axis M钉道进钉点与椎动脉和寰椎椎动脉沟内缘交界处的距离。结果Axis M钉道进钉点对应寰椎后弓上缘皮质与椎动脉的距离为(2.2±1.1)mm。Axis M钉道进钉点对应寰椎后弓上缘皮质与椎动脉和寰椎椎动脉沟外缘交界处的距离为(2.1±1.1)mm。Axis M钉道进钉点与寰椎横突孔外层皮质最短距离为(9.1±1.9)mm。Axis M钉道进钉点与椎动脉和寰椎椎动脉沟内缘交界处的距离为(9.4±1.5)mm。结论测量C_(1)椎弓根螺钉置入Axis M钉道进钉点与椎动脉的距离,有助于理解寰椎经椎弓根螺钉置入进钉点与椎动脉的相对空间位置关系。

Objective The relationship between insertion point of C_(1) transpedicular screw insertion trajectory Axis M(Axis M IP)and vertebral artery(VA)was studied for C_(1) transpedicular screw insertion.Methods A total of 60 patients’neck CTA data from picture archiving and communicating system were underwent retrospectively reconstruction by workstation.The following parameters were measured:A.distance between superior aspect of C_(1) posterior arch over Axis M IP and VA.B.distance between superior aspect of C_(1) posterior arch over Axis M IP and the intersection of VA and outer aspect of vertebral artery groove.C.the shortest distance between Axis M IP and outer cortex of C_(1) transverse foramen.D.distance between Axis M IP and the intersection of VA and vertebral artery groove inner aspect.Results The distance between superior aspect of C_(1) posterior arch over Axis M IP and VA was(2.2±1.1)mm.The distance between superior aspect of C_(1) posterior arch over Axis M IP and the intersection of VA and outer aspect of vertebral artery groove was(2.1±1.1)mm.The shortest distance between Axis M IP and outer cortex of C_(1) transverse foramen was(9.1±1.9)mm.The distance between Axis M IP and the intersection of VA and vertebral artery groove inner aspect was(9.4±1.5)mm.Conclusion The measurements of relationship between Axis M IP and VA are conducive to understand the relationship between the insertion point of C_(1) transpedicular screw insertion and VA.