内镜引导下经后路上颈椎螺钉内固定的应用解剖  

Applied anatomy of using posterior upper cervical spine screw fixation by endoscopy

作　　者：罗特坚[1] 曾铁功[2] 易德保[1] 屈庆元[2] 

机构地区：[1]邵阳医学高等专科学校人体解剖学教研室,湖南邵阳422000 [2]邵阳医学高等专科学校附属医院脊柱外科

出　　处：《解剖学研究》2009年第5期374-376,共3页Anatomy Research

基　　金：湖南省科技计划项目(2008-SK-3029)

摘　　要：目的探讨内镜引导下经后路上颈椎螺钉内固定的应用解剖,为临床经后路C2/3椎弓根螺钉固定术提供解剖学资料。方法选用干骨28套(C1-7),对其滋养孔的位置、椎弓根等相关数据进行了观察和测量。结果C2/3的滋养孔距后正中线分别为(17.26±7.36)和(16.05±7.95)mm;椎弓根的长、高、宽(mm)分别为6.18±1.36、8.87±2.22、11.54±3.21和4.95±3.5、7.00±0.97、10.50±4.11;椎弓根的中轴线与正中矢状切面所构成的夹角分别为(43.83±3.09)°和(41.53±3.29)°。结论临床经后路C2/3椎弓根螺钉内固定手术,进螺点可选定在C2/3侧块距其外侧缘5mm、距下关节突下缘8mm处,螺钉进入的延长线与正中矢状切面的夹角应为40°～45°,并向头侧倾斜10°为宜,螺钉的长度为24～30mm,覬为5mm为佳。Objective To discuss the applied anatomy of using posterior upper cervical spine screw fixation by Endoscopy and provide materials of human anatomy for using posterior C2/3 Pedicle screw fixation in clinic. Methods Using 28 sets of dried bones ,the position of nutrient foramen and related data of pedicle were observed. Results C2/3＇s nutrient foramen was 17.26±7.36 and 16.05±7.95 mm distance from posterior median line, the length, height and width of pedicle were 6.18±1.36, 8.87 ±2.22, 11.54 ±3.21 mm, 4.95±3.5, 7.00 ±0.97, 10.50 ±4.11 mm,respectively. The angles between medial axis and median sagittal section of Pedicle were 43.83°±3.09°and 41.53°±3.29° 10 respectively. Conclusion Using posterior C2/3 Pedicle screw fixation in clinic, we can choose the side mass of C2/3 that is 5 mm distance from its lateral border and 8mm distance from inferior articular process lower margin as the inlet screw point. The angle between extension cord and median sagittal section is between 40° to 50°, especially leaning 10° to cephalic part. The better thing for the length is 24 to 30mm and 24 is 5 mm.

关 键 词：上颈椎 经后路 螺钉内固定 内镜 应用解剖 

分 类 号：R687.3[医药卫生—骨科学]