Dimensiones del arco posterior de C2 para el guiado de tornillos translaminares. Estudio radiológico en población española

  1. B. Vázquez-García
  2. C. Villas
  3. J. Pueyo
  4. J. Broncano
  5. C. Donat-Vargas
  6. M. Alfonso
Revista:
Anales del sistema sanitario de Navarra

ISSN: 1137-6627

Ano de publicación: 2020

Volume: 43

Número: 3

Páxinas: 323-331

Tipo: Artigo

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Outras publicacións en: Anales del sistema sanitario de Navarra

Resumo

Fundamento. Describir la capacidad del arco posterior de C2 en población española para colocar dos tornillos cruzados translaminares. Método. Se reclutaron 150 pacientes a los que se les realizó un escáner del cuello por patología no cervical. Para el estudio se utilizó un 64 multi-detector TAC realizando cortes submilimétricos (0,7 mm de grosor) cada 0,4 mm, permitiendo obtener medidas isométricas. Se midieron anchura y altura cortical y endomedular de la lámina y de la espinosa, inclinación de la lámina, máxima longitud de tornillo y ángulo espinolaminar. Resultados. Las media (desviación estándar) de las medidas de la lámina fueron: anchura cortical izquierda 7.2 (1,5) mm, cortical derecho 6,9 (1,3) mm, anchura endomedular izquierda 4,8 (1,5) mm, derecha 4,6 (1,4) mm La altura media cortical izquierda fue 13,0 (1,5) mm y de 13,1 (1,6) mm para la derecha. La altura media endomedular fue de 9,0 mm en ambos lados. Las medidas medias de la espinosa fueron: longitud media cortical 15,7 (3,5) mm, longitud endomedular 12,5 (3,9) mm; altura cortical 11,9 (2,2) mm, altura endomedular de 8,4 (2,1) mm; ángulo espinolaminar 49º (4); la longitud máxima de tornillo 3,18 cm; y el ángulo de inclinación 143º. Conclusiones. Para evitar la colocación errónea de los tornillos es necesario un estudio de TAC con cortes submilimétricos. La diferencia entre las medidas corticales y endomedulares oscila entre 2 y 4 mm. Teniendo en cuenta las dimensiones de la espinosa, un 24% de la población no sería candidato a esta técnica de tornillos cruzados translaminares.

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Fonte de datos: Dialnet