多层螺旋CT检查在尸体颈椎损伤中的应用

对需要在尸体检验时进行颈椎多层螺旋CT(MSCT)检查的情形进行讨论,研究利用MSCT对疑有颈椎损伤的尸体进行颈椎检查的方法,并对一例疑似颈椎损伤尸体的颈椎提取后进行MSCT检查。发现对疑似有颈椎骨折尸体提取颈椎进行MSCT检查,可以快速精确地显示颈椎的细微骨折及骨折的空间分布,从而推断致伤方式。解决了传统尸检中费时费力,容易漏诊和误诊的问题。     

第12胸椎三维重建图像性别判定研究

目的考察计算机断层扫描(CT)技术测量中国汉族第12胸椎判定性别的效果,探索CT技术在法医人类学人体骨骼测量研究中应用的可行性。方法确定11项径线指标测量第12胸椎多层面重组(MPR)三维重建图像,剔除不稳定指标后计算四项比值指标,统计各项指标的数据考察CT测量第12胸椎判定性别的效果。结果剔除两次测量结果不稳定的三项指标后的12项指标性别差异显著,建立了7个性别判定方程,综合判别率在80.0%~91.6%,仅含椎体指标的方程性别判别率最高达91.6%。结论中国汉族人第12胸椎形态学测量指标具有性别差异,CT技术可以准确测量骨骼,对法医人类学人体骨骼测量研究具有应用价值。     

A meta-analytic review of the frequency and patterning of laryngohyoid and cervical fractures in cases of suicide by hanging

The frequency and distribution of fractures are commonly utilized to assist in interpreting the manner of death. In cases of alleged suicide by hanging, however, the evidence base for the frequency and patterning of laryngohyoid and cervical vertebrae fractures resulting from such blunt force traumatic events is limited and so fractures cannot be reliably used to assist in interpreting the manner. Using meta-analytic techniques, this study aimed to estimate frequency and distribution of fractures in the context of relevant intrinsic and extrinsic variables. A systematic review of the literature identified 20 studies with relevant data (8523 cases of suicide by hanging). Meta-analyses identified the frequency and distribution of fractures present and how fracture frequency was affected by the subgroups of age, sex, completeness of suspension, ligature knot position and study design. Results indicated that fracture frequency was variable, there was no unique patterning, and high levels of heterogeneity were present in all variable sub-groups. Age was the only subgroup to show differences. Findings suggest that neck fracture frequency is inconsistent and cannot be predicted by the chosen variables. Subsequently, neck fractures in isolation should not be given weight in medico-legal interpretations of a hanging death as suicidal.     

Sexual Dimorphism in the 7th Cervical and 12th Thoracic Vertebrae from a Mediterranean Population

Sex determination is an important task in physical anthropology and forensic medicine. The study sample comprised 121 individuals of known sex, age, and cause of death from San Jose cemetery in Granada (Spain). Eight dimensions were analyzed, and discriminant function analysis was performed for each vertebra to obtain discriminating functions and study the percentage of correct assignations of these functions. The percentage accuracy was approximately 80% for both vertebrae, but varied according to the sex, being higher for the 7th cervical in males and higher for the 12th thoracic in females. As reported in other populations, the greatest dimorphism values were found for the length of the inferior surface of the vertebral body and the width and length of the vertebral foramen of the 7th cervical vertebra and for the length of the inferior surface of the vertebral body of the 12th thoracic vertebra.     

中国汉族人腰椎的性别差异

目的提供体质人类学的数据资料 ,建立中国汉族腰椎性别判别的方法。方法根据人体骨骼测量方法 ,测量 117付 (男 80 ,女 3 7付 ,年龄 17～ 90岁 )中国汉族人腰椎的 10项指标 ;选择性别差异显著的椎测量项目 ,建立腰椎及各腰椎的性别判别方程。结果第一至第五腰椎均有 5个以上的测量项目的数据存在显著意义的性别差异 (P<0 0 5 ) ;建立的 5个腰椎及各腰椎的性别判别方程 ,判别率在 69 4%～ 91 8% ,以 5个腰椎的多项指标的性别判别方程的准确率最高 (91 8% ) ,其次为第一腰椎 (84 5 % )和第二腰椎 (82 1% )。结论中国汉族人腰椎的性别差异以第一和第二腰椎明显 ,腰椎性别判定以多项指标的准确率高     

A Method for Articulating and Displaying the Human Spine

Abstract:  An inexpensive and effective method for articulating a dry human spine is described. By constructing a Styrofoam™ spine tray, analysts can now accurately position and align each vertebra in correct anatomical order, allow for gaps because of missing vertebrae, and lay out the spine for documentation and photography. The spine tray provides analysts with a quick, easy, and professional quality method for aligning and orienting the human spine in the field and laboratory.     

经伤椎置单向椎弓根螺钉结合十七味大活血胶囊治疗无神经损伤胸腰椎压缩性骨折疗效观察

目的 观察伤椎置入单向椎弓根螺钉结合十七味大活血胶囊口服在无神经损伤胸腰椎压缩性骨折治疗中的效果。方法 将67例无神经损伤胸腰椎骨折患者,根据患者最终选取的治疗方案分为对照组（n=45）和观察组（n=22）。对照组给予跨伤椎固定的基础上再经伤椎置入单向椎弓根螺钉固定,观察组在对照组的基础上使用自制十七味大活血胶囊口服。分别观察两组治疗前、治疗后1周、治疗后3个月椎前缘高度、椎中缘高度和后凸角度,视觉模拟量表（visual analogue scale,VAS）评分,日本骨科协会（Japanese Orthopaedic Association,JOA）评分。结果 与治疗前比较,两组治疗后1周、3个月椎前缘高度、椎中缘高度均明显增加（P＜0.05）,后凸角度均明显减小（P＜0.05）;观察组治疗后3个月椎前缘、椎中缘高度均明显高于对照组（P＜0.05）。与治疗前比较,两组治疗后VAS评分在治疗后1周、3个月均明显减少（P＜0.05）,JOA评分均明显增加（P＜0.05）。观察组治疗后VAS评分在治疗后1周、3个月均显著低于对照组（P＜0.05）,JOA评分明显高于对照组（P＜0.05）。结论 经伤椎置入单向椎弓根螺钉结合十七味大活血胶囊口服更利于伤椎前中柱交界处的复位,临床疗效更好。     

枢椎种族差异的初步研究

目的探讨枢椎椎骨在种族间是否存在差异。方法对黄种人已知确切性别的33例枢椎椎骨进行研究,测量枢椎椎骨的8项指标,所得数据与白种人进行比对。结果8项指标中,其中6项指标在男性种族间存在显著的种族差异、3项指标在女性种族间存在显著的种族差异。结论枢椎椎骨在种族方面存在一定差异,可以进行进一步的深入研究,本文对骨骼种族方面的鉴定研究有一定的借鉴意义。     

Integrating Growth Variability of the Ilium,Fifth Lumbar Vertebra,and Clavicle with Multivariate Adaptive Regression Splines Models for Subadult Age Estimation

Subadult age estimation should rely on sampling and statistical protocols capturing development variability for more accurate age estimates. In this perspective, measurements were taken on the fifth lumbar vertebrae and/or clavicles of 534 French males and females aged 0–19 years and the ilia of 244 males and females aged 0–12 years. These variables were fitted in nonparametric multivariate adaptive regression splines (MARS) models with 95% prediction intervals (PIs) of age. The models were tested on two independent samples from Marseille and the Luis Lopes reference collection from Lisbon. Models using ilium width and module, maximum clavicle length, and lateral vertebral body heights were more than 92% accurate. Precision was lower for postpubertal individuals. Integrating punctual nonlinearities of the relationship between age and the variables and dynamic prediction intervals incorporated the normal increase in interindividual growth variability (heteroscedasticity of variance) with age for more biologically accurate predictions.     

Determination of sex for the 12th thoracic vertebra by morphometry of three-dimensional reconstructed vertebral models

Thirty-three linear measurements and two ratios were derived from 102 12th thoracic vertebrae of the Digital Korean database at the Catholic Institute for Applied Anatomy. Of 35 linear traits, 23 were sexually dimorphic. We created 23 discriminant function equations that predicted sex with 62.7-85.3% accuracy. The analysis using combinations of two factors gave higher accuracies: most equations with accuracies over 80% included at least one measurement involving the coronal diameter of the vertebral endplate. Using stepwise method of discriminant function analysis, three variables predicted sex with 90.0% accuracy: the coronal diameter of the superior endplate of the vertebral body, the ratio of anterior to middle height of the body, and the length of the left mammillary process and pedicle. Coronal dimensions of the vertebral body represented the major sex difference. These equations will help forensic discrimination of the sex of this vertebra among Koreans.