经口前路枢椎腹侧解剖学观察与临床意义  

Transoral Ventral Anterior Atlantoaxial Anatomy Study and Its Clinical Significance

作　　者：徐宏伟 刘振华[2] 牛国旗[2] 周建生[2] 吴敏[2] 林国兵[1] 郭文荣[1] 

机构地区：[1]南京军区福州总医院第一附属医院骨科,福建省莆田市351100 [2]蚌埠医学院第一附属医院骨科

出　　处：《中国骨与关节损伤杂志》2011年第5期391-393,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的对枢椎腹侧进行解剖学观察测量研究，探讨经口前路枢椎腹侧多个螺钉固定的可行性及临床意义。方法随机选取15具完整头颈尸体标本．对枢椎腹侧骨性结构进行观察测量，观察枢椎腹测形态结构。结果枢椎腹侧结构特殊，两侧枢椎体凹陷，椎动脉在枢椎体两侧基本呈直线向上进入侧块再折转向后外方。枢椎体腹侧高度为（20．42±0．90）mm，椎动脉内侧缘距枢椎中线的距离（12．28±1．17）mm，枢椎体前方正中线到枢椎体外侧缘的距离为（10．83±1．23）mill，枢椎体上方预设进钉点，距中线9mm，距上关节面约5mm处，横断面上，该点到枢椎后方的垂直距离为（12．74±1．48）mm，该点至枢椎后方正中的距离为（15．21±1．31）mm，自该进钉点进钉。当内倾范围在0．170时，可有安全、合适的进钉角度。结论对于需要经口前路固定治疗寰枢椎疾病，枢椎腹侧解剖结构可以行多个螺钉固定，适当的进钉角度，有助于提高寰枢椎前路固定的稳定性。Objective To investigate the feasibility and clinical significance of the ventral anterior adantoaxial screw fixation with the ventral axis measurement of anatomy. Methods Fifteen full cadavers were randomly selected. The ventral axis of the structure of bone was observed and measured, and the ventral axis measuring morphology was observed. Results The following were observed： the special structure of the ventral axis, axis vertebra on both sides of depression, both sides of the vertebral artery in the axis vertebra into the side of the basic linear speed up, then turn off after the foreign, the ventral axis vertebral height（20.42±0.90） mm, medial margin of the vertebral artery from the midline axis distance of（12.88±1.17） mm,founder midline axis to the anterior lateral edge of the vertebral axis distance of （10.83±1.23）mm, axis vertebra at the top of the default entry points, from the middle 9 mm, about 5 mm from the articular surface department, the cross section, the point to the rear of the vertical axis distance of （12.74±1.48） mm, the point-to-axis distance after the founder of （15.21±1.31）mm, from the entrance point into the nail, when the tilt range of 0-17°, it could be the safe, appropriate entry angle. Conclusion The need for transoral fixation for treatment of anterior atlantoaxial disease, anatomical ventral axis screw fixation can be multiple lines, the appropriate entry angle, help to improve the way fixed atlantoaxial stability.

关 键 词：枢椎 解剖 经口前路 

分 类 号：R681.5[医药卫生—骨科学]