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目的:测量下颈椎椎间孔螺钉的钉道长度及角度参数,并与椎弓根螺钉和侧块螺钉进行比较。方法:选取2018年1月至2018年6月连续进行健康查体的受检者,共50名(男25名,女25名)的颈椎CT影像资料,年龄(56.00±15.90)岁(范围:29~89岁)。对受检者的CT数据进行三维重建,依据椎间孔螺钉、椎弓根螺钉、侧块螺钉(Magerl法)置钉技术的进钉点和钉道设计在三维重建模型上选定后进行调整,在调整完毕的重建图像上分别对Cn 3~Cn 7节段进行钉道长度和进钉角度测量,记录其最大内倾角、最适内倾角、最小内倾角、最适钉道长度、椎弓根宽度等参数测量值。间隔2周由同1名脊柱外科医生对各影像学参数再次进行测量,取两次测量的平均值。n 结果:颈椎椎间孔螺钉总体最适钉道长度和内倾角分别为Cn 3 10.65 mm,21.12°;Cn 4 10.12 mm,22.62°;Cn 5 9.82 mm,23.66°;Cn 6 9.19 mm,24.13°和Cn 7 9.10 mm,27.54°。Cn 3节段总体最适钉道长度最长;Cn 7节段总体最适钉道长度最短(n F=19.287,n P <0.001),但与Cn 6节段的差异无统计学意义(n P=0.674)。Cn 7节段总体最适内倾角最大,Cn 3节段总体最适内倾角最小(n F=19.752,n P <0.001)。男性在Cn 4、Cn 6、Cn 7节段最适钉道长度长于女性(Cn 4t=2.912,Cn 6t=3.884,Cn 7t=5.468,n P <0.05),并在Cn 4、Cn 6、Cn 7节段最适内倾角小于女性(Cn 4t=3.560,Cn 6t=4.370,Cn 7t=4.738,n P <0.05)。椎弓根螺钉总体最适钉道长度和内倾角分别为Cn 3 30.94 mm,33.92°;Cn 4 30.50 mm,34.95°;Cn 5 31.92 mm,33.42°;Cn 6 30.50 mm,31.94°和Cn 7 29.87 mm,31.01°;总体椎弓根宽度分别为Cn 3 5.35 mm;Cn 4 5.56 mm;Cn 5 5.99 mm;Cn 6 6.34 mm和Cn 7 6.86 mm。侧块螺钉总体最适钉道长度为Cn 3 14.84 mm;Cn 4 15.33 mm;Cn 5 15.44 mm;Cn 6 14.74 mm;Cn 7 14.06 mm。颈椎椎间孔螺钉总体最适钉道长度在Cn 3~Cn 7节段为9.10~10.65 mm,均短于侧块螺钉和椎弓根螺钉(n P <0.05),总体最适进钉内倾角在Cn 3~Cn 7节段为21.12°~27.54°,均小于椎弓根螺钉(n P <0.05)。n 结论:椎间孔螺钉长度受限,不具备直接损伤椎动脉的风险,进钉角度较椎弓根螺钉陡直,且具有较大的进钉安全角度,可作为颈椎椎弓根螺钉和侧块螺钉的有效补充。“,”Objective:To measure and compare the length and angle parameters of the screw paths of paravertebral foramen screws (PVFS), pedicle screws (PS) and lateral mass screws (LMS) of subaxial cervical spine.Methods:This study included the cervical computerized tomography (CT) scans of 50 healthy volunteers (25 males and 25 females) in our hospitalfrom January 2018 to June 2018. The average age of the volunteers was 56.00±15.90 years (range, 29-89 years). After three-dimensional reconstruction of CT data, the screw starting points, length of screw paths,optimal medial angles, maximum medial angles and minimum medial angles of PVFS, PS and LMS (Magerl technique) on Cn 3-Cn 7 segments were designed and measured on the reconstructed 3D model, and the pedicle widths at various segments of cervical vertebrae were measured. All parameters were measured twice in an interval of two weeks by one orthopaedic surgeons with experience in spine surgery, and the average values of the two measurements were used.n Results:In general, the optimum length and medial angle of the PVFS in Chinese population were 10.65 mm and 21.12° at Cn 3; 10.12 mm, 22.62° at Cn 4; 9.82 mm, 23.66° at Cn 5; 9.19 mm, 24.13° at Cn 6; and 9.10 mm, 27.54° at Cn 7. The Cn 3 segment had the longest general optimal length, and the Cn 7 segment had the shortest general optimal length of PVFS (n F=19.287, n P<0.001). However, there was no significant difference in optimal length of PVFS between Cn 6 and Cn 7 vertebrae (n P=0.674). The Cn 7 vertebra had the largest general medial angle, meanwhile the Cn 3 vertebra had the smallest general medial angle (n F=19.752, n P<0.001). The optimum lengths of screw path of PVFS in males at the segments of Cn 4, Cn 6 and Cn 7 vertebrae were longer than those in females (Cn 4t=2.912, Cn 6t=3.884, Cn 7t=5.468, n P<0.05), and the optimal medial angle at Cn 4, Cn 6 and Cn 7 segments were smaller than those in females (Cn 4t=3.560, Cn 6t=4.370, Cn 7t=4.738, n P<0.05). The optimum length and medial angle of PS in Chinese population were 30.94 mm, 33.92° at Cn 3; 30.50 mm, 34.95° at Cn 4; 31.92 mm, 33.42° at Cn 5; 30.50 mm, 31.94° at Cn 6; and 29.87 mm, 31.01° at Cn 7. The general pedicle widths were 5.35 mm at Cn 3; 5.56 mm at Cn 4; 5.99 mm at Cn 5; 6.34 mm at Cn 6; and 6.86 mm at Cn 7. The optimum lengths of LMS paths in Chinese population were Cn 3, 14.84 mm; Cn 4, 15.33 mm; Cn 5, 15.44 mm; Cn 6, 14.74 mm; and Cn 7, 14.06 mm. In Chinese population, the optimal length of PVFS was 9.10-10.65 mm, and the optimal medial angle was 21.12°-27.54°. The general optimal length of PVFS path were shorter than those of LMS and PS at Cn 3-Cn 7 segments (n P<0.05), and the general optimal medial angles were smaller than those of PS at Cn 3-Cn 7 segments (n P<0.05).n Conclusion:Because of the length of screw path of PVFS is limited, it does not have the risk of direct vertebral artery injury. The insert angle of PVFS is steeper and safer than that of PS. In summary, cervical PVFS can be used as an effective supplement to PS and LMS.