前路枢椎椎弓根螺钉固定通道的CT测量及临床应用  

CT measurement and clinical application of transoral pedicle screws channel in axis

作　　者：郑轶[1,2] 吴增晖[1] 章凯[1] 尹吉林[3] 马向阳[1] 尹庆水[1] 殷一红[2] 

机构地区：[1]广州军区广州总医院骨科医院,广州市510010 [2]广州中医药大学研究生处,广州市510405 [3]广州广州军区广州总医院PET-CT中心,广州市510010

出　　处：《中国脊柱脊髓杂志》2009年第9期656-658,共3页Chinese Journal of Spine and Spinal Cord

基　　金：广东省自然科学基金团队项目(编号:20023001)

摘　　要：目的:探讨CT扫描测量指导前路枢椎椎弓根螺钉置入的临床应用价值。方法:对20具干燥枢椎标本行椎弓根螺钉置入,然后应用CT测量进针的角度、钉道长度以确定最佳进钉点,并根据测量数据和术前影像学检查对10例难复性寰枢椎脱位患者行前路寰枢椎复位椎弓根螺钉固定植骨融合术,观察寰枢椎复位及螺钉位置情况。结果:枢椎椎弓根的平均长度为25mm,进针点距离枢椎正中线6.6mm,安全进钉的角度向外倾斜21°±2°,下倾10°±2°。10例患者寰枢椎均完全复位,枢椎椎弓根螺钉均位于椎弓根钉道内。结论:前路寰枢椎椎弓根螺钉固定有较高的安全性,术前行CT扫描对于前路寰枢椎内固定手术有重要的指导意义。Objective：To investigate the CT measurement and clinical application of transoral pedicle screws channel in axis.Method：20 dry axis specimen were used for pedicle screw placement,the anchoring point,orientation and length of pedicle screws chnnel were determined under CT eross-setional scan.Based on the data collected and preoperative radiography,10 cases of irreducible atlantoaxial dislocation experienced transoral pediele screw placement,the status of reduction and screw placement were reviewed retrospectively.Result：The average axis pedicle length was 25mm,the anchoring point was 6.6mm laterally to the midline with the safe orientation of 21°±2° extroversion and 10°±2° down inclination.10 cases surgically managed received complete reduction with all screws positioning well and no perforation of pediele screw.Conclusion：Transoral pedical screw fixation in axis has higher safety,preoperative CT-scan is critical in guiding the transoral pediele screw placement.

关 键 词：枢椎 椎弓根 CT扫描 

分 类 号：R687.3[医药卫生—骨科学]