寰椎侧块解剖学观测及其在侧块螺钉固定中的应用  

Applied Anatomy of Mass Lateralis Atlantis and Its Application in Internal Fixation Operation

作　　者：柯新[1] 郑启新[1] 熊晓芊[1] 赵明[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022

出　　处：《华中科技大学学报（医学版）》2006年第6期799-800,809,共3页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的 通过对寰椎解剖学特征进行观测,为临床寰椎侧块螺钉内固定手术提供解剖学依据.方法 收集10例成年尸体寰椎标本,使用游标卡尺进行线性测量;角度测量则先用钨丝取模,再用常规量角器检测.测量指标包括后弓内侧半距、后弓外侧半距、后弓高度、后弓宽距、侧块外侧高度、侧块内侧高度、侧块横径、侧块前后径、侧块内倾角.两例患者依据测量的解剖学数据,选在寰椎后结节中点旁20 mm与后弓下缘以上3 mm的交点处进钉,置入侧块螺钉后行X线检查,观察螺钉在寰椎侧块中的长度及与矢状面的角度.结果 后弓外侧半距为(20.8±3.3)mm,后弓高度为(7.2±1.7)mm.两例患者X线片显示螺钉均在寰椎侧块内,螺钉长度25 mm,与矢状面保持(8～14)°.结论 寰椎侧块螺钉的进钉点选在寰椎后结节中点旁20 mm与后弓下缘以上3 mm的交点处,与矢状面保持(8～14)°.Objective To investigate the anatomic parameters of the atlas so as to provide anatomic clues for lateral mass screw-plate internal fixation in atlas.Methods The data were achieved in 10 atlas specimens of the corpses of normal adults,including inside semi-diameter of the arcus posterior atlantis,outside semi-diameter of the arcus posterior atlantis,height of the arcus posterior atlantis,width of the arcus posterior atlantis,height of the interior lateral mass,height of the exterior lateral mass,width of the lateral mass,anteroposterior diameter of the lateral mass and angle of inclination of the lateral mass.According to the data obtained,the screw was placed at the cross point which was 20 mm beside the midpoint of atlantal posterior tubercle and 3 mm above the inferior margin of arcus palatinus posterior in 2 patients.Then,X-ray examination was performed and the length and angle of screw in atlas were measured.Results Outside semi-diameter of the arcus posterior atlantis was(20.8±3.3) mm.Height of the arcus posterior atlantis was(7.2±1.7) mm.X-ray examination revealed that the screw was in atlas.And the length of the screw was 25 mm.The angle between the screw and vertical plane was(8-14)°.Conclusion The screw should be placed at the cross point which is 20 mm beside the midpoint of atlantal posterior tubercle and 3 mm above the inferior margin of arcus posterior atlantis during the operation of atlantal lateral mass screw-plate internal fixation.

关 键 词：寰椎侧块 螺钉 

分 类 号：R687.32[医药卫生—骨科学]