| 杨晓江,张 扬,田瑞军,蒋明春,雷 伟.颈后路单开门椎管扩大成形术中椎板实际开门宽度、椎管横径与椎管横截面积增加值的相关性研究[J].,2017,17(34):6679-6683 |
| 颈后路单开门椎管扩大成形术中椎板实际开门宽度、椎管横径与椎管横截面积增加值的相关性研究 |
| Investigation on Relationship of Actual Laminoplasty Opening Size, Length of the Most Medial Points of the Bilateral Laminar Gutters, and Increased Value of the Cross-sectional Area |
| 投稿时间：2017-08-23 修订日期：2017-09-15 |
| DOI：10.13241/j.cnki.pmb.2017.34.016 |
| 中文关键词: 颈后路单开门椎管扩大成形术 椎管横截面积 椎板实际开门 |
| 英文关键词: Single-door cervical laminoplasty Cross-sectional areas Actual laminoplasty opening size |
| 基金项目:国家自然科学基金项目(81501885) |
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| 中文摘要: |
| 摘要 目的：推导单开门椎管扩大成形术中椎板实际开门宽度、椎管横径与椎管横截面积增加值关系的公式，并利用公式预测椎管横截面积增加值并验证其有效性。方法：通过术前术后椎管形态变化建立几何模型，根据三角函数知识推导单开门椎管扩大成形术中椎板实际开门宽度、椎管横径与椎管横截面积增加值关系的公式：s增加 = b/2×√(2&a^2-b^2/4)=(c-d)/2×√(2&a^2-〖(c-d)〗^2/4) (其中a为椎管横径，b为实际开门大小，c为使用钛板尺寸，d为使用磨钻直径)。通过患者术前术后CT图像，测量公式中相关参数，并代入公式得出术后椎管横截面积的预测增加值，通过统计学方法分析利用公式预测的椎管横截面积增加值与实际测量得出的椎管横截面积增加值之间的差异，从而验证公式在实际应用中的可行性。结果：25例病例均获得术前术后完整的CT影像学资料。对每个病例手术相关节段术前术后椎管横截面积进行逐一对比差异均有统计学意义(P＜0.01)。通过公式计算所得各节段椎管横截面积增加值与实际测量的椎管横截面积增加值逐一进行对比差异均无统计学意义(P＞0.05)。结论：在单开门椎管扩大成形术中，应用公式根据实际椎板开门宽度及椎管横径能准确计算椎管横截面积增加值，指导术者在术前根据需要选择合适的钛板。 |
| 英文摘要: |
| ABSTRACT Objective: To mathematically model the correlation of actual laminoplasty opening size (LOS), length of the most medial points of the bilateral laminar gutters, and increment of the cross-sectional area. The results from realistic samples in single-door cervical laminoplasty (SDCL) will be applied to further verify the accuracy and effectiveness of the mathematical modeling formula. Methods: After analyzing the deformation of spinal canal before and after the surgery, a characterizing formula for this regular geometric model is derived as, s△BAB' = b/2×√(2&a^2-b^2/4)=(c-d)/2×√(2&a^2-〖(c-d)〗^2/4) , where a is the length of the most medial points of the bilateral laminar gutters, b the actual LOS, c the size of the mini-plate，and d is the diameter of drill bit used in the operation. The proposed parameters would be analogically or digitally measured before the surgery or procedure. For each subject sample, the values of a, b, c, and d are plugged in the formula to determine the increment of the cross-sectional area after an operation. Thus, the calculation from the mathematical model will be compared with the realistic measurement of each subject sample. The results will be statistically analyzed to verify the feasibility of the modeling in practical applications. Results: In this project, a total number of 25 patients are authorized and participated in the investigation. Their CT SCAN of C3~C7 were used as the subject samples. It is discovered that there exist significant variation of the cross-sectional area for each patient before and after his or her surgery in each specific segment (P＜0.01). However, there was no significant difference between the cross-sectional area value added attained by formula and the data measured by software in the same segment (P＞0.05). Conclusion: Increment of the cross-sectional area due to the SDCL can be accurately predicted by the above-mentioned modeling formula. It means that, before each SDCL, the formula enables the physician or operator to select the most suitable mini-plate before operation for each patient, which will highly improve the accuracy and success of the surgery. |
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