7-12岁儿童脊柱颈段数字化三维形态发育研究

In recent years, external trauma, deformity, tuberculosis, tumor of childen's have taken on a rising trend gradually, children's (aged 7-12) cervical vertebra morphological development, mechanical change, location of pathogeny, clinical presentation, as well as diagnoses and treatment involve many special methods. However, there are few systematic fundamental research reports pertaining to the whole cervical vertebra structure. Digital three dimensional (3D) reconstruction technology can provide clear, direct-observed, three-dimensional imaging information for basic research and clinical diagnoses and treatment. What's more, this technology has been applied in the measurement of cervical vertebra morphology, design of surgery, making navigation template, evaluation of post-surgery, finite-element analysis, design of artificial tissues and organs, making orthopedic apparatus, design of internal and external fixator, human engineering research and so on. So far, there have been few studies on children's cervical vertebra. The academic project performs systematic digital three-dimensional morphological measurement, MSCT and MR 3D reconstruction quantitative among different patients of different age groups and gender groups, infinit-element mechanical measurement, analysis of bone density by multi-discipline application and research, to explore the characteristics of children's cervical vertebra morphological development, biological mechanical change, internal fixation technology and regularity between age and bone density and provide theoretical evidence for making artificial vertebra, vertebra disc, orthopedic apparatus, internal and external fixators, as well as preventing and treating various cervical vertebra diseases.

近年来儿童颈椎外伤、畸形、结核、肿瘤及颈椎病等呈递增趋势，而7～12岁儿童颈椎形态发育、力学变化、发病部位、临床表现及诊治方法等独特之处甚多，国内外鲜见对其全颈椎相关结构的系统基础研究。数字化三维重建技术可为基础研究和临床诊治提供清晰、直观、立体的三维影像信息，已应用于成人脊柱形态测量、手术设计、导航模板制作、术后评估、有限元分析、人工组织器官设计与生产、矫形仪及内外固定器设计和人体工效学研究等领域，但对该年龄段儿童颈段系统研究甚少。课题拟行该年龄段儿童全颈椎及椎间盘等软组织分年龄、性别与侧别系统的数字化三维形态测量、MSCT和MR三维重建定量、有限元力学检测、骨密度分析，通过多学科交叉应用研究，探索该年龄段颈椎形态发育特征、生物力学变化、内固定技术标准及年龄界限与骨密度增龄变化规律，为设计国人儿童人工椎骨及间盘、矫形仪、颈围领、内外固定器和预防诊治各型颈椎病等提供理论依据。

通过本课题研究，基本确定了国人7-12岁儿童颈椎各结构，尤其是椎弓根“力学核心”、椎间盘及终板软骨的形态发育特征、解剖毗邻关系及生物力学变化；提供了其C1-C7椎弓根内固定术中前路和后路螺钉内固定的进钉点、进钉方向、螺钉最佳直径及进钉深度等相关数据，已在临床应用并取得了良好效果；经组织学和免疫组化观测，在此年龄段并未发现钩椎关节存在滑膜，实验中儿童冷冻尸体不能行MRI扫描，需完全解冻后扫描，同时探索了三维立体无创性准确定量的研究方法；为创建该年龄段儿童颈椎椎弓根螺钉固定技术标准、理论依据和最佳方案积累了实验数据，也为设计人工椎骨及椎间盘、矫形仪、固定器和诊治儿童脊柱脊髓创伤、畸形、结核、肿瘤、退变等提供了理论依据。课题研究过程规范、严谨、具有创新性并按计划如期完成；发表学术论文23篇，资助培养了9名研究生完成了7-12岁儿童颈椎相关结构的数字化三维形态测量和有限元分析方面的科研课题；其成果参编出版了3部专著、8部教材，协助成功审批内蒙古自治区“数字转化医学工程技术研究中心”和国家级“蒙医学虚拟仿真实验教学中心”，同时成立了“内蒙古数字转化医学学会”，为从事基础、临床及数字转化搭建了全新的科研、教学服务平台。