一种后路寰枢椎动态内固定系统的研制及其解剖学研究  

Design and preparation of a posterior atlanto-axial dynamic fixation system and the corresponding anatomical study

作　　者：周风金[1] 倪斌[1] 刘洪超[2] 陈金水[1] 郭翔[1] 李松凯[1] 

机构地区：[1]第二军医大学附属长征医院骨科,上海200003 [2]第二军医大学附属长征医院影像科

出　　处：《脊柱外科杂志》2011年第3期183-187,共5页Journal of Spinal Surgery

摘　　要：目的根据影像学测量数据,设计一种符合人体局部解剖结构的后路寰枢椎动态内固定器,并为其相关研究提供解剖学基础。方法选取50例正常成年人颈椎CT片,依次测量C1后结节高度,C1后结节上缘至C2椎板上缘的距离,C1后结节上缘至C2椎板下缘的距离,C1后结节与C2棘突最高点的水平高度差,两侧C2椎弓根螺钉进针点与C2椎板上缘最高点的夹角和C2椎弓根螺钉进针点与C2椎板上缘最高点的距离。根据测量数据设计一种符合人体局部解剖结构的后路寰枢椎动态内固定器。结果将内固定器安装在颈椎模型上,进行屈伸、左右侧屈、水平旋转及其复合活动的正常人体活动模拟,观察其活动度,并将其与无内固定加载的颈椎模型进行比较,发现加载内固定后寰枢椎间的屈伸活动明显受限,而其他活动无明显受限。结论通过相应部位的影像测量证实后路寰枢椎动态内固定系统设计合理,既能有效治疗寰枢椎脱位,同时也保持寰枢椎的活动功能。Objective To design and prepare a posterior atlanto-axial dynamic fixation system according to imaging data,and to conduct anatomical measurement of the atlantoaxial complex so as to provide relevant data for the system.Methods The cervical vertebra CT images of 50 adults were chosen for determination of the following anatomical data： the height of C1 posterior tubercle,distance between superior margins of C1 posterior tubercle and C2 lamina,distance from superior margin of C1 posterior tubercle to inferior margin of C2 lamina,and distance from the entry point of C2 pedicle screw to superior margin of C2 lamina,sagittal height difference between C1 posterior tubercle and C2 spinous process,and the angle of each side of C2 pedicle screw entry point with C2 lamina superior margin.Based on the data,a nove1 adult posterior atlanto-axial dynamic fixation system was designed using a universal titanium alloy connector,four polyaxial screws,an curved rod,and two rods with thread at one side.Results The system was used on the cervical vertebra model and normal human movements were simulated,including bend,extension,left and right lateral bending,left and right axial rotation,and complex movement.The range of motion of the model was observed and the results were compared with that without the system.We found that the bend and extension was greatly limited,and other motions were not notably limited.Conclusion The corresponding imaging findings indicate that the design of posterior atlanto-axial dynamic fixation system is reasonable;it may be effective for treatment of atlanto-axial dislocation and can guarantee the atlanto-axial range of motion.

关 键 词：寰椎 关节不稳定性 内固定器 关节动度测量法 关节 

分 类 号：R681.531[医药卫生—骨科学]