枢椎交叉椎板螺钉置钉的应用解剖  

Cadaveric morphometric analysis for placement of the axis crossing laminar screws

作　　者：黄师[1] 赵鑫[1] 侯铁胜[1] 李新[2] 

机构地区：[1]第二军医大学长海医院骨科,上海200433 [2]右江民族医学院解剖学教研室,右江530015

出　　处：《解剖学杂志》2009年第1期110-111,共2页Chinese Journal of Anatomy

摘　　要：目的:测量中国成年人枢椎椎板的相关解剖学参数,探讨枢椎交叉椎板螺钉置钉的可行性。方法:取60具成年人干燥枢椎标本,测量双侧椎板的厚度、高度、钉道长度以及椎板长轴和矢状面的夹角。结果:成年男性枢椎椎板的厚度、高度、钉道长度以及椎板长轴和矢状面的夹角分别为(5.93±1.54)mm、(10.98±1.47)mm、(28.04±3.41)mm、47.840±6.380,成年女性分别为(5.18±1.32)mm、(9.97±1.64)mm、(25.89±3.85)mm、46.160±5.820,不同性别间的椎板厚度、高度、钉道长度差异有统计学意义,左、右侧之间差异无统计学意义。85.8%的椎板厚度大于或等于4mm,78.3%大于或等于5mm。结论:枢椎交叉椎板螺钉在解剖学上是可行的,能够在直视下操作,可准确估计钉道的长度以及进钉角度,避免椎动脉和神经根的损伤。Objective： To measure laminar anatomic parameters of axis in Chinese adults and evaluate the feasibility of place- ment of crossing laminar screws in the axis. Methods： 60 axis specimens of Chinese adults were collected （32 males, 28 females）. The average age was 55 years, ranging from 25 to 72 years. And bilateral laminar thickness, height, length of the screw tract and the angle between the axis of lamina and sagittal plane were measured. Results： I.aminar thickness, height, length of screw tract and the angle between the axis of lamina and sagittal plane were 5.93±1.54 mm, 10. 984±1.47 ram, 28.04±3.41 mrn and 47.840±6.38o in males respectively, while 5.18±1.32 mm, 9.97±1.64 mm, 25.89±3.85 rnm, and 46.16°±5.82° in females respectively. The difference of laminar thickness, height and length of screw tract was significant between male and female （P〈0.05）, but there was no significant difference between left and right sides. 85.8% laminas had a thickness equal or more than 4 ram, and 78.3 % equal or more than 5 ram. Conclusion： The cadaveric morphometric analysis shows that it is acceptable for the placement of axis crossing laminar screws and the angle and length of the screw tract can be estimated precisely under direct vision, thus avoiding injuries of the vertebral artery and nerve roots.

关 键 词：枢椎 解剖学 内固定 

分 类 号：R687.3[医药卫生—骨科学] R683.2[医药卫生—外科学]