极外侧经枕骨髁-侧块入路治疗自发性寰枢椎脱位的临床解剖学  

Clinical anatomy of the extreme lateral occipital condyle-lateral mass approach in the idiopathic atlanto-axial dislocation

作　　者：缪国专[1] 杜长生[1] 周定标[2] 杜心如[3] 

机构地区：[1]武警总医院神经外科,北京100039 [2]解放军总医院神经外科,北京100853 [3]首都医科大学附属北京朝阳医院骨科,北京100020

出　　处：《中国临床解剖学杂志》2008年第5期485-487,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:探讨极外侧枕骨髁—侧块入路的可行性及解剖学基础。方法:(1)通过50个干性寰枢椎标本的测量,主要测量齿突和寰椎外侧缘的平均高度;(2)6具成人尸体标本在显微镜操作下模拟手术入路。结果:齿突的平均高度(14.84±2.55)mm,寰椎外侧缘的高度左侧(17.38±2.49)mm,右侧(17.28±2.52)mm。齿突的平均高度明显低于寰椎外侧缘的高度(P≤0.01);该入路仅需磨除部分寰椎侧块,就能够很好的显露齿突。结论:极外侧枕骨髁—侧块入路治疗自发性寰枢椎脱位,可以不磨除枕骨髁,就能满意显露齿突。该入路有足够的空间行该部位的植骨融合术。Objective： To investigate the feasibility and anatomic basis of extreme lateral occipital condylelateral mass approach. Methods： Average heights of odotoid and atlas lateral border were concluded by measurement of dry axis and atlas in 50 cases. Surgical approach was simulated in 6 cadaveric heads under the microscope. Results： Average height ofodotoid was about （14.84±2.55）mm, atlas lateral border （17.38±2.49） man（L） and （17.28±2.52）mm （R）. Atlas lateral border was higher than that of odotoid usually （P≤0.01）. Odotoid can be displayed clearly after stripping part of lateral mass during this surgical approach. Conclusions： For dealing with idiopathic atlanto-axial dislocation, it is unnecessary to mill occipital condyle during the extreme lateral occipital condyle- lateral mass approach. This approach can also offer enough space for fusion of bone in the region.

关 键 词：极外侧入路 解剖 寰枢椎脱位 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]