小儿寰椎解剖及其对骨折治疗的影响:解剖学和放射学研究

IF 0.7 4区 医学 Q4 NEUROSCIENCES Neurocirugia Pub Date : 2024-07-01 DOI:10.1016/j.neucir.2024.01.001
Lucie Salavcová , Jan Štulík , Vojtěch Štulík , Michaela Rybárová , Gábor Geri , Ondřej Naňka
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引用次数: 0

摘要

引言和目的该研究的目的是:(1) 描述寰椎在生长过程中的形状变化,包括性别和侧面的差异;(2) 评估确定最佳进入点的基本尺寸;(3) 根据我们自己的限制参数确定将 3.5 毫米螺钉安全插入外侧肿块的年龄限制。材料和方法对 200 例 0-18 岁个体的颅颈交界处 CT 扫描和 34 例第一颈椎解剖标本(2.5-18 岁)进行了寰椎尺寸测量。这两个系列均按性别和年龄划分。结果寰椎的生长速度在 0 至 2 岁期间达到最大值,随后生长速度减慢,一直持续到 18 岁。C1 椎孔的尺寸比例随着年龄的增长而变化。最年幼的儿童左侧椎弓根到右侧椎弓根的距离相对较大;5 岁左右,两个数值趋于一致,随后前弓内壁到后弓内壁的距离相对较大。横孔在整个生长过程中都略呈椭圆形。该研究证明,从 5 岁开始,所有患者的侧方肿块大小都足以插入 3.5 毫米螺钉。对于年龄较小的儿童,应尊重患者的解剖结构,并相应调整手术技巧。
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Pediatric atlas anatomy and its implications for fracture treatment: an anatomical and radiological study

Introduction and objectives

The objective of the study was: (1) to describe changes in the shape of the atlas during growth, including gender and side differences; (2) to assess the dimension essential for identification of the optimal entry point; (3) to determine the age limit for a safe insertion of 3.5-mm screws into the lateral masses according to our own limiting parameters.

Materials and methods

Dimensions of the atlas were measured on 200 CT scans of the craniocervical junction in individuals aged 0–18 years and on 34 anatomical specimens of the first cervical vertebra (aged 2.5–18 years). Both series were divided according to the gender and age. The values measured on CT scans were used for statistical comparison of data in boys and girls and comparison of the right and left sides.

Results

The atlas reaches its maximum growth rate between 0 and 2 years of age, then the growth decelerates and continues until the age of 18 years. The proportion of dimensions of C1 vertebral foramens changes with age. The youngest children show a relatively greater distance from the left to the right medial pedicle; around the age of 5 the values get even and subsequently the distance from the inner wall of anterior to posterior arch gets relatively greater. The transverse foramen has a slightly oval shape throughout the period of growth. Statistically significant differences between boys and girls were observed primarily between 12 and 18 years of age.

Conclusion

The study has proved adequate size of lateral masses for insertion of 3.5-mm screws in all patients from the age of 5 years. In younger children, the patient´s anatomy should be respected and the surgical technique tailored accordingly.

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来源期刊
Neurocirugia
Neurocirugia 医学-神经科学
CiteScore
1.30
自引率
0.00%
发文量
67
审稿时长
60 days
期刊介绍: Neurocirugía is the official Journal of the Spanish Society of Neurosurgery (SENEC). It is published every 2 months (6 issues per year). Neurocirugía will consider for publication, original clinical and experimental scientific works associated with neurosurgery and other related neurological sciences. All manuscripts are submitted for review by experts in the field (peer review) and are carried out anonymously (double blind). The Journal accepts works written in Spanish or English.
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