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目的探讨儿童下颈椎椎弓根形态特征及其发育规律,为椎弓根螺钉内固定提供形态学依据。方法收集4~12岁儿童颈椎MSCT扫描资料60例,按每隔3岁为一年龄组,共分为3组,每组20例。将原始数据导入Mimics软件3D重建,在3D模型上测量C3~7椎弓根宽(PW)、椎弓根高(PH)、椎弓根骨通道全长(POCL)、外偏角(e角)及尾偏角(f角)并计算PW/PH(I值),按年龄组及节段行统计分析。结果 PW、PH、POCL及e角总体随增龄呈递增趋势,10~12岁组各椎的PW、PH及POCL均与4~6岁组、7~9岁组有差异(P<0.05),e角和f角在不同年龄组间差异不大。在各组中不同椎序的PW均表现为逐增趋势。PH、POCL及e角在各组中椎间差异不大。各组中椎间f角差异较大,由正值渐变为负值,C7的f角为负值中最大。I值总体随年龄增长呈递减趋势,不同年龄组间C3~7的I值由>1.0渐变为<1.0;各组中椎间均无差异(P>0.05)。结论不同节段椎弓根形态特征发育规律性明显,但也存在个体差异性。4岁以上儿童下颈椎椎弓根形态上已具有置入椎弓根螺钉的可行性。
Objective To investigate the morphological characteristics and developmental rules of pedicles of lower cervical pedicle and to provide morphological evidence for pedicle screw fixation. Methods 60 cases of MSCT scan data of cervical spine from 4 to 12 years old were collected. They were divided into 3 groups, 20 cases in each group. The original data were imported into the Mimics software for 3D reconstruction. The 3D pedicle width (PW), pedicle height (PH), total pedicle bone channel length (POCL), external angulation angle (e angle ) And caudal angle (f angle) and calculate PW / PH (I value), by age group and segmental line statistical analysis. Results The PW, PH, POCL and e angle all showed an increasing tendency with age. The PW, PH and POCL of each vertebra of 10 ~ 12 years old group were different from those of 4 ~ 6 years old group and 7 ~ 9 years old group (P <0.05) , e angle and f angle in different age groups is not different. The PWs of different vertebral sequences in each group showed an increasing tendency. PH, POCL and e angle in each group little difference between the intervertebral. In each group, the intervertebral f angle was significantly different from positive to negative and the angle of C7 was the largest among negative values. The value of I gradually decreased with age. The I value of C3-7 in different age groups changed from> 1.0 to <1.0. There was no difference in the intervertebral space in each group (P> 0.05). Conclusion Different segments of the pedicle morphology characteristics of the development of regularity, but there are also individual differences. Pediatric pediatric children under 4 years old cervical pedicle screw has the feasibility of pedicle screw placement.