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目的 :测量多个解剖标志与上终板平面之间的角度,寻找颈胸段(C6~T6)脊柱后路手术术中椎弓根螺钉矢状面徒手进钉角度(sagittal screw angle,SSA)新的定位技术。方法:选择60例(男女各30例)正常成人颈胸段(C6~T6)CT片,分别测出上终板平面在矢状面上与同一椎骨棘突与相邻上棘突顶点连线夹角(方法 1);相邻下棘突顶点连线夹角(方法 2);同一椎骨棘突嵴线夹角(方法 3);同一椎骨左侧椎板平面的夹角(方法 4);右侧椎板平面的夹角(方法 5)。得出每个椎骨各种方法的参考值,比较各方法的优劣,采用其中一种或者几种方法作为颈胸段(C6~T6)脊柱后路手术椎弓根螺钉矢状面徒手进钉角度定位新技术。结果:上终板平面和同一椎骨棘突与相邻上下棘突顶点连线夹角在下颈椎C6到C7段角度在100°~110°之间且数值差异较大,在上胸椎T1到T6两种方法的角度值趋于90°,差异相对较小;上终板平面和同一椎骨棘突嵴线夹角从C6到T6角度值逐渐变小;上终板平面和同一椎骨左右侧椎板平面夹角基本为90°即垂直位。结论:在颈胸段(C6~T6),当椎弓根螺钉垂直于椎板平面进钉时,即椎弓根螺钉在矢状面上角度为0°,椎板平面可作为颈胸段(C6~T6)椎弓根螺钉矢状面徒手进钉角度的解剖标志。
OBJECTIVE: To measure the sagittal screw angle (SSA) of sagittal pedicle screw sagittal plane in posterior approach of cervical spine (C6 ~ T6) New positioning technology. Methods: Sixty patients (30 males and 30 females) underwent CT scan of the C6 thrombi in the thoracic spine (C6 ~ T6). The plane of the upper end plate was measured on the sagittal plane and connected with the vertebrae of the same vertebra (Method 1), the angle between the vertices of adjacent spinous processes (Method 2), the angle between the spine crest of the same vertebra (Method 3), and the angle between the plane of the left vertebral plate of the same vertebra (Method 4) The angle of the right lamina plane (Method 5). Get the reference value of each method for each vertebra, and compare the merits of each method, using one or several methods as the cervical thoracic (C6 ~ T6) posterior approach pedicle screw sagittal freehand nail Angle positioning of new technologies. Results: The angle between the upper end plate plane and the spinous process of the same vertebra and the vertexes of the adjacent upper and lower spinous processes was between 100 ° ~ 110 ° in C6 ~ C7 of lower cervical spine. The angles of the methods tend to be 90 ° with relatively small differences. The angle between the upper endplate plane and the spine of the same vertebrae gradually decreases from C6 to T6. The plane of the upper end plate and the plane of the left and right lamina of the same vertebra The angle is basically 90 ° vertical position. Conclusions: In the cervical thoracic (C6 ~ T6), when the pedicle screw is perpendicular to the plane of the lamina, the angle of the pedicle screw in the sagittal plane is 0 ° and the plane of the lamina can be used as the neck and thoracic segment C6 ~ T6) anatomical landmarks of pedicle screw sagittal screw angle.