新型上颈椎前路钩状钛板的研制及应用解剖学基础  

The designation and anatomic basis of the neotype retropharyngeal cervical vertebra hook-plate

作　　者：王文军[1] 蔡斌[1] 宋西正[1] 赵延胜[1] 

机构地区：[1]南华大学附属第一医院脊柱外科,湖南衡阳421001

出　　处：《中国临床解剖学杂志》2009年第4期459-463,共5页Chinese Journal of Clinical Anatomy

摘　　要：目的:通过解剖测量C1～3获得形态学参数为研制上颈椎前路钩状钛板提供解剖学依据。方法:采用40套正常成人干燥寰枢椎骨标本及50例正常成人颈椎侧位X线片测量C1～3的相关参数,并进行统计学分析,据此设计上颈椎前路钩状钛板,并在3具成人尸体标本上模拟钩状钛板置入并植骨术。结果:寰椎前弓宽度(AW)为(20.06±1.16)mm、前弓高度(AH)(10.61±1.04)mm、前弓厚度(AT)(4.09±0.66)mm;齿突横径(DW)(9.80±0.83)mm、齿突前后径(DD)(10.13±0.63)mm;枢椎椎体前缘高(VAH)(22.03±1.99)mm、前缘横径(TD)(16.80±1.26)mm、前后径(AP)(16.14±1.06)mm;寰枢椎前缘总高度(AAOH)(37.44±3.2)mm、C2/3椎间盘前缘高(C2/3IVDHA)(4.55±0.64)mm、C3椎体前缘高(C3BHA)(13.31±1.39)mm。前路钩状钛板由一对钩形钛板和配套螺钉构成,其中钛板分为C1～2和C1～3两种型号。结论:颈椎前路钩状钛板的设计在形态学上具有可行性,各部件参数有一定的选取范围,其能在颈前侧咽后入路下安装,既能够避免进口咽入路的并发症又能重建寰枢关节的稳定性,具有牢靠安全、操作简便的特点。Objective： To explore anatomic features of C1-3 vertebrae, and provide parameters for the evelopment of the neotype retropharyngeal cervical vertebra hook-plate （RCHP）. Methods： 40 sets of dry atlanto-axonal specimens and 50 sets of Chinese adults＇X ray data of lateral neck vertebrae were used in this study. The width, thickness and height of anterior arch of atlas （AW, AT and AH）,transverse and anterorposterior distance of odontoid process （DW and DD）, anterior height and transverse distance and anterorposterior distance of vertebra dentata （VAT, TD and AP）, anterior overall height of atlanto-axial joint （AAOH）, anterior height of C2/3 intervertebral disc （C2/3IVDHA）, and anterior height of C3 vertebral body （C3BHA）were measure and analyzed. Results： AW was about （20.06±l.16）mm,AH （lO.61±l.04）mm,AT （4.09±0.66）mm,DW （9.80±0.83）mm, DD （ 10.13±0.63 ）mm, VAH （22.03±1.99）mm, TD （ 16.80±1.26）mm, AP （ 16.14±1.06 ）mm, AAOH （37.44±3.2）mm, C2/3IVDHA （4.55 ±0.64 ）mm, and C3BHA （ 13.31 ±1.39 ）mm respectively. The internal fixation device composed of a couple of hook-plates including C1-2 type and C1-3 type. Conclusions： The designation of retropharyngeal cervical vertebra hook-plate is feasible anatomicly. Every part of the fixation device has different parameter ranges. It can be installed successfully to reconstruct the stability of atlanto-odontoid joint, by cervicum anterolateral approach, which is safe and convenient method.

关 键 词：应用解剖 寰枢关节 钛板 内固定 上颈椎 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]