目的:C4是上颈椎和下颈椎之间的过渡点,在颈椎中部起着举足轻重的作用。目前,关于儿童C4解剖学的大规模样本研究的报道有限,小儿颈椎手术经验不足。当前的研究解决了大量儿童样本中C4椎弓和侧块的解剖学测量的缺乏。这项研究旨在测量不同年龄段的14岁以下儿童的C4椎弓和侧块的影像学解剖。研究这些结构的生长和发育。
方法:我们测量了12个指标,包括大小(D1、D2、D3、D4、D5、D6、D7和D8)和角度(A,C,D,和E)C4椎弓和侧块,在我们医院接受宫颈CT检查的513名儿童中。我们使用聚合函数进行统计分析,对差异统计量进行t检验,并利用最小二乘法进行回归分析。
结果:总体而言,随着年龄的增长,椎弓和侧块的大小逐渐增加。此外,椎弓内侧倾角减小,侧块逐渐变平。随着年龄的增长,变化率逐渐降低。D1的平均值从2.31mm增加到3.88mm,D2从16.75毫米到29.2毫米,D3从2.21毫米到4.92毫米,D4从7.34毫米到11.84毫米。同时,D5的平均值从5.2毫米增加到9.71毫米,D6从10.19毫米到16.16毫米,D7从2.53毫米到5.67毫米,和D8从6.11毫米到11.45毫米。角度A的范围为49.12°至54.97°,角C从15.28°到19.83°,角度D从39.91°到53.7°,和角度E从18.63°到28.08°。
结论:在儿童颈椎手术之前,细致的CT成像解剖测量至关重要。成像数据作为后C4内固定的参考,有助于为儿科患者设计颈椎后路螺钉,为小儿颈椎后路手术及螺钉设计提供形态学解剖学参考。
OBJECTIVE: The
C4 is the transition point between the upper and lower cervical vertebrae and plays a pivotal role in the middle of the cervical spine. Currently, there are limited reports on large-scale sample studies regarding
C4 anatomy in children, and a scarcity of experience exists in pediatric cervical spine surgery. The current study addresses the dearth of anatomical measurements of the
C4 vertebral arch and lateral mass in a substantial sample of children. This study aims to measure the imaging anatomy of the
C4 vertebral arch and lateral mass in children under 14 years of age across various age groups, investigate the growth and development of these structures.
METHODS: We measured 12 indicators, including the size (D1, D2, D3, D4, D5, D6, D7, and D8) and angle (A, C, D, and E) of the
C4 vertebral arch and lateral mass, in 513 children who underwent cervical CT examinations at our hospital. We employed the aggregate function for statistical analysis, conducted t-tests for difference statistics, and utilized the least squares method for regression analysis.
RESULTS: Overall, as age increased, there was a gradual increase in the size of the vertebral arch and lateral mass. Additionally, the medial inclination angle of the vertebral arch decreased, and the lateral mass flattened gradually. The rate of change decreased gradually with age. The mean value of D1 increased from 2.31 mm to 3.88 mm, of D2 from 16.75 mm to 29.2 mm, of D3 from 2.21 mm to 4.92 mm, and of D4 from 7.34 mm to 11.84 mm. Meanwhile, the mean value of D5 increased from 5.2 mm to 9.71 mm, of D6 from 10.19 mm to 16.16 mm, of D7 from 2.53 mm to 5.67 mm, and of D8 from 6.11 mm to 11.45 mm. Angle A ranged from 49.12° to 54.97°, angle C from 15.28° to 19.83°, angle D from 39.91° to 53.7°, and angle E from 18.63° to 28.08°.
CONCLUSIONS: Prior to cervical spine surgery in children, meticulous CT imaging anatomical measurements is essential. The imaging data serves as a reference for posterior C4 internal fixation, aids in designing posterior cervical screws for pediatric patients, and offer morphological anatomical references for posterior cervical spine surgery and screw design in pediatric patients.