寰枢椎骨折经皮撬拨复位的临床应用解剖学研究  

Applied Anatomy of Percutaneous Reduction of Atlantoaxial Fracture

作　　者：魏思奇[1] 李保良[1] 王兴水[1] 王建民[1] 王虎[1] 孙永建[1] 谭建文[1] 孙景福[1] 

机构地区：[1]广东省东莞市厚街医院骨科,523945

出　　处：《解剖与临床》2006年第5期315-316,319,共3页Anatomy and Clinics

摘　　要：目的：通过对寰枢椎的解剖观测，为寰枢椎骨折经皮撬拨复位螺钉固定术提供解剖学参数。方法：在5例经防腐处理头颈部标本上模拟寰枢椎骨折经皮撬拨复位术并进行体表定位，术中用直尺和量角器测量经皮撬拨齿突、寰椎侧块的进钉点及进钉方向，在X线片和断层标本上测量撬拨针通道及深度。结果：测出经寰椎侧块撬拨齿突进针点位于乳突下方1．5cm（1．3～1．7cm），乳突前方1．2cm（1．0～14cm）；进针方向与正中矢状线的夹角约为60°（55°～65°）、与水平面间的夹角为5°（3°～7°）；进针深度7cm（6．2～6．8cm）等体表定位参数。实验5例经寰椎侧块对齿突撬拨，未发生损伤神经、血管及撬拨针滑人椎管损伤颈髓等情况。结论：寰枢椎骨折具备经皮撬拨复位、寰枢关节螺钉内固定的条件。Objective：To observe the atlantoaxial anatomical position,in order to provide anatomical basis for percutaneous reduction by leverage and screw fixation in the treatment of atlantoaxial fracture. Mefllods：Tbe sham operated of atlantoaxial fractures were performed on 5 antiseptic cadavers and adumbrated on these dead body surfaces. During operation, the point and direction of screw inserting at percutaneous leverage dens and massa latemlis atlantis were measured by vernier caliper and conimeter, the passage and depth of teasing needle were detected by X- ray. Results： The inserting point was in the inferior of temporal apophysis 1.5cm（1.3～ 1.7cm） and in the anterior ofapophysis 1.2cm（1.0～ 14cm）.The direction of nail inserting and meso sagittal line formed an acute angel of 60° （55 ～ 65°）. The included angle between the direction of nail inserting and horizontal plane was 5° （3～7°） .The depth of needling was 7cm（6.2 ～ 6.8cm） .5 cases received dens leverage through massa lateralis atlantis had no complications such as nerves and vessels injury, and cervical cord damage because teasing needle slipped into vertebral canal. Condusion：Atlantoaxial fracture can be treated by percutaneous reduction by leverage and screw internal of atlanto- axial joint.

关 键 词：寰枢椎骨折 撬拨 复位 固定 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R687.3[医药卫生—基础医学]