| Objective: Cervical pedicle screw fixation technology ismore and more mature and wide.But cervical pedicle smaller thanthoracolumbar pedicle, cervical pedicle screw trajectoryincline angulationis closely related to the effect of surgery and surgical safety. Somescholars have already studied entry points, incline angulation,sagittalangles data of the cervical pedicle screw. Cervical spinal stenosis is thebasis of the morbidityin a variety of spinal cord compression, cervicalspinal stenosis is often accompanied by abnormal cervical bone structure,characterized by short pedicle development，vertebral plate flat，cervicalspine radiographs showed the line of lamina and spinous processcombined often overlap in the cervical lateral mass margin line. Thecervical pedicle screw trajectoryincline angulation datas of the patients inthe two groups,wereanalysed in this retrospective study,bycomparingwith cervical spinal stenosis patients and non-cervical spinal stenosispatients differences within the cervical pedicle screwtrajectoryinclineangulation,to discusses the rule of cervical pedicle screwtrajectoryincline angulation change.Methods:There were a total of486cases admitted to department of spinal surgery,the Affiliated Hospital ofLuzhou Medical College with degenerative cervical spondylosis or cervical spinal injury.The patients with cervical spinal stenosis on accountof ossification of posterior longitudinal ligaments, multiple segmentalvertebral osteophyte, ossification of ligamentumflavum and cervicalfracture and dislocation, infectious or tumoral lesions, or congenitalspinal malformation and the rheumatoid arthritis or prior spine surgerywere excluded. After X-ray inspected in the prone position and the neckwas in the neutral position, the ratio value of cervical canal sagittal weremeasured by AutoCAD software,all of the patients were divided intocervical spinal stenosis group(A group) and non-cervical spinal stenosisgroup(B group) on the basis of0.75. According to the inclusion criteriaand exclusion criteria that68patients were recruited in the group A and52patients were recruited in the group B. CTimage data were obtainedusing a multislice scanner in0.625-mm slices from the level of the C3toC7. We obtained transverse Computed Tomography scan through thesagittal plane parallel to cervical pedicle. Axial images of the largestpedicle diameter were selected to analyse. The cervical pedicle screwentry point were demarcated on the CT image data according to Abumi’s,cervical pedicle screw trajectoryincline angulation which is the anglebetween the entry point with pedicle minimum diameter of the midpointattachment lines and the sagittalmidline of the vertebral body. The meanvalueof the left and right side of the cervical pedicle screwtrajectoryincline angulation were compared between groups.Thecervical pedicle screw trajectoryincline angulation and the ratio value of cervicalcanal sagittal correlation were analyzed by pearsong’s.Results:The leftand right side of the cervical pedicle screw trajectoryincline angulationand the gender difference of the cervical pedicle screw trajectoryinclineangulation were not significantly different between the two groups（P>0.05）.The incline angulation gradually decreases from C3toC7,C343.13.9,C446.13.5,C543.44.8,C638.35.4,C726.34.2， whichrules were C3＜C4＞C5＞C6＞C7.There were no significantdifferences(P0.05） of the cervical pedicle screw trajectoryinclineangulation between cervical spinal stenosis group and non-cervical spinalstenosis group. Allpatiensin the tow groups at the same vertebral bodymay consult the same incline angle range when the process of cervicalpedicle screw insertion.The analysis by pearsong’s for the total of240trajectory in the two groups showed there had no correlation between theinclineangulation and the ratio of cervical canalsagittal.Conclusions:1.For the same vertebral body, thecervical pediclescrew trajectoryinclineangulationwas not significantly different betweenthe cervical spinal stenosis and non-cervical spinal stenosis,both can referto the same incline angle range while insert the cervical pediclescrew.2.The incline angle in the both sides of the pedicle had nosignificant difference for the same vertebra. There were large differencesinthecervical pedicle screwtrajectoryincline angle forthe same individual from C3-C7,TheC4was the largest, and the C7was thesmallest.Thevariation range of the cervical pedicle screw inclineanglesfor different individuals in different cervical vertebral.5.The inclineangulation no correlation with the ratio value of cervical canal sagittal. |
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