| BackgroundThe main cause of nerve root type cervical spondylosis is stenosis of intervertebral foramen compression of spinal nerve.It' s the most common clinical cervical spondylosis,and the incidence accounts for about 50?60%of the total number of all types of cervical spondylosis.The causes of intervertebral foramen stenosis is common in osteophyte extrusion,acute trauma,small joint dislocation,chronic strain and vertebral osseous and soft tissue factor such as ectopic,cause intervertebral foramen smaller.Thus a nerve root compression inflammation,such as edema and adhesion,causing a series of clinical symptoms.Among them,the judge whether intervertebral foramen stenosis is an important indicator of intervertebral foramen area size.A lot of clinical treatment of cervical spondylosis and evaluation methods are associated with intervertebral foramen area change has very big relevance.Cervical traction technology commonly used as a technique for one kind of cervical spondylosis of nerve root type,is a kind of controllable axial traction method,the methods have been used in clinical in 1929,is one of the recognized treatment for cervical spondylosis,its curative effect.Is by means of mechanical stretch cervical traction technology,separation of articular surface,drafting the surrounding soft tissue,and the relative elongation,and changing the Angle between the bony structure,etc.,one of its main purpose is to increasing the intervertebral foramen area,reduce the nerve root compression,so as to achieve the corresponding therapeutic effect.However,for different traction Angle influence on intervertebral foramen area size,reports and related research is less,the main reason is confined to the cervical spine Angle simulation and measurement results are not accurate,therefore,cannot get the exact morphological parameters.To known 3D structure through two-dimensional plane image registration,reproduce the position relations of three-dimensional structure,hereinafter referred to as 2 D/3D registration technology.Cervical vertebra oblique X-ray examination is cheap,simple operation,less radiation,patients are more likely to accept,is currently the most common clinical examination method.However,X-ray can only show part of the intervertebral foramen,some can not be displayed.The bone around the intervertebral foramen of cervical intervertebral foramen overlap,imaging is poor.Low accuracy of the morphological parameters of the intervertebral foramen.Three-dimensional CT examination radiation dose high,and MRI examination check will take a long time,There prices are expensive,requiring high patient compliance,and there are some contraindications.At the same time,CT,MRI examinations are using horizontal position,mostly limited to the position,etc.This study adopts the 2D/3D registration techniques to measure,can be very good to avoid the shortcoming,for different positions of cervical vertebra 3D model.Ye Qiang etc.[3]have shown that the 2D/3D registration technique can be used to obtain the accurate data of intervertebral foramen parameters.But did not do further research on the accuracy.Therefore,In this study,the three-dimensional model of cervical spine was obtained by CT data of cervical vertebrae,and the three-dimensional morphology of the cervical spine was rebuilded by 2D/3D registration technique.The 2D/3D registration technique was used to measure the accuracy of the morphology of the cervical spine.To provide scientific basis for the traction treatment of nerve root cervical spondylosis,and provide a theoretical basis for the improvement of cervical traction.ObjectiveThis experiment bases on the 2D/3D registration technique to measure the parameters of intervertebral foramen morphology in vitro,and to study the accuracy of the method.And combined with the adjustable neck support technology to investigate the effects of different angles on the morphological parameters of intervertebral foramen.Methods1.Three dimensional models of 16 cervical spine specimens were obtained by three-dimensional reconstruction.All specimens were taken lateral X-ray,application of 2D/3D registration technology to restore the three-dimensional position for shooting flat cervical vertebra.Rapidform XOR3 software was used to measure the intervertebral foramen area,anteroposterior diameter and upper and lower diameters of C2/3 to C6/7 after registration and registration.2.The cervical spine CT of 7 healthy volunteers was measured,and the original data were reconstructed by three-dimensional reconstruction software Mimics.Accurating reduction of the cervical spine in 0 degrees,after extended to 10 degrees,over flexion of 10 degrees and over flexion of 20 degrees with the basic information of the cervical spine C2 to C6 each segment of the bony structure of the 2D/3D registration.The cervical intervertebral foramen area,anteroposterior diameter and upper and lower diameters of C2/3 to C5/6 were measured.Results1.158 area of intervertebral foramen,anteroposterior diameter and upper and lower diameter were measured,the accuracy of intervertebral foramen was 96.77%,the anteroposterior diameter was 94.35%and the upper and lower diameter was 96.14%.The accuracy of the intervertebral foramen was(1.27 ± 1.16)mm2,the anteroposterior diameter was(0.30 ± 0.27)mm,and the upper and lower diameters were(0.32 ± 0.28)mm.Compared with the pre-registration,the registration area of the intervertebral foramen,anteroposterior diameter,vertical diameter showed no significant difference(P>0.05)by paired samples t-test.2.There were 224 of the area of intervertebral foramen,anteroposterior diameter and top and bottom diameter were measured.When the cervical vertebra was over 20 degrees,the difference of the intervertebral foramen area,the anteroposterior diameter and the growth rate of all cervical segments were greater than those of other traction angles.Single factor analysis of variance was used to compare the P value of the difference between the 20 degree and the neutral position at the height of 0 degrees,and the growth rate was less than 0.05,the results were statistically significant.In the upper and lower diameter,the difference of all cervical segments(at 20 degrees)was higher than that of other angles,but there was no significant difference in growth rate.By single factor analysis of variance,the difference of traction angle and growth rate,P values were greater than 0.05,the results were not statistically significant.Conclusion1.2D/3D registration technique has high accuracy and precision in measuring the morphological parameters of cervical intervertebral foramen.2.2D/3D registration technique combined with adjustable neck support technology can reflect the influence of different traction angles on the morphological parameters of intervertebral foramen.3.Over flexion 20 degree traction can effectively increase the intervertebral foramen area and anteroposterior diameter. |
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