MSCT Reconstruction in Designing the Pedicle Screw Trajectory before Operation in Atlantoaxial Lesions / 实用放射学杂志

ABSTRACT

Objective To evaluate the clinical value of multislice spiral CT(MSCT) reconstruction in designing the pedicle screw trajectory before operation in atlantoaxial lesions.Methods 37 patients with upper cervical abnormality treated by surgery for atlantoaxial or occipitoaxial interfixation and/or fusion were undergone MSCT scan,and the 3D anatomical data(including the length,width and height of each pedicle,the angle between the pedicle and sagittal plane,and the thickness of internal occipital crest) were measured on volume reconstruction(VR) and multi-plane reconstruction(MPR) images and used for surgeon to select advisable pedicle screws(including the proper length and diameter) and to ensure the comfortable point,depth and direction for screw position at preoperation.The patients were followed up by atlantoaxial X-ray image and/or MSCT reconstruction to estimate the veracity of the screw position.Results All the patients were operated successfully,of them,5 patients were treated by simply atlantoaxial fixation,15 by atlantoaxial fixation and fusion,4 by simply occipitoaxial fixation,11 by occipitoaxial fixation and fusion,2 by atlantoaxial fixation and occipitoaxial fusion.X-ray images and/or MSCT reconstruction revealed that atlantoaxis were reposition entirely and all the screws were at predesigned trajectory.All the patients were followed up and no screw was broken or loosen and no atlantoaxial redislocation was found.Conclusion MSCT reconstruction for designing pedicle screw trajectory in atlantoaxial lesions before operation is satisfactory and valuable for clinical application.