虚拟手术系统支持下寰椎侧块螺钉固定相关数据的测量  

The date measurement of atlas lateral mass screw fixation by use of the virtual surgery system

作　　者：何建荣 李超 杨会武[2] 何飞[2] 黄河[2] 

机构地区：[1]云南大理州医院骨科,671000 [2]昆明医学院第一附属医院骨科,650032

出　　处：《中国矫形外科杂志》2012年第2期152-155,共4页Orthopedic Journal of China

基　　金：昆明市社会发展科技计划重点项目(编号:08S100311);云南省科技计划联合专项(编号:2008C0013R)

摘　　要：[目的]通过结合当前虚拟手术系统辅助手术的优势,测量寰椎侧块螺钉固定通道的相关数据。[方法]选取8例16侧无破损和畸形的寰椎(C1)防腐头颈标本,先行CT扫描,后将数据导入虚拟手术系统进行重建,测量寰椎侧块数据:选择侧块与后弓根部下方交界区和横突孔的内侧缘与寰椎后弓内侧壁中点为进钉点,测量,L1:横突孔的内侧缘与寰椎后弓内侧壁的距离,L2:进钉点与侧块前缘最高点的距离,L3:进钉点与侧块前缘的垂直距离,α:进钉点的垂线与寰椎侧块上缘切线的角度,β:进钉点垂线与横突孔内侧缘切线的角度,γ:进钉点垂线与侧块内侧缘切线的角度,内斜角度δ:(β+γ)/2-β。左右两侧均测量3次,取其均值,进行统计学分析。[结果]虚拟手术系统测量寰椎侧块相关参数L1、L2、L3、α、β、γ、δ,经统计学分析,左右侧测量值均无统计学差异(P>0.05)。[结论]选择侧块与后弓根部下方交界区处寰椎后弓内壁外约5 mm为进钉点,侧块螺钉进钉深度在18～22 mm,上倾斜约18°～20°,在矢状位上可内收6°。[ Objective ] To measure the data related to screw fixation passage of atlas lateral mass, combining with the advantages of current virtual surgery system. [ Method] Eight cases （ 16 sides） of anticorrosive atlas （ C1 ） without damage or malformation underwent CT scans,then the CT data was transferred to the virtual surgery system and reconstructed to measure the data of atlas lateral mass. The junctional zone of lateral mass and underside of posterior arch pedical and midpoint of inner border of transverse foramen and inner wall of the posterior arch of atlas was selected as screw insertion point. The following param- eters were measured ：the distance between the inner border of transverse foramen and the inner wall of the posterior arch of atlas （ L1 ） ,the distance between screw insertion point and highest point of front border of lateral mass （L2 ） , the vertical distance between screw insertion point and highest point of front border of lateral mass （ L3 ） ,the angle between perpendicular of screw insertion point and tangent of up border of lateral mass （α） , the angle between perpendicular of screw insertion point and tangent of inner border of transverse foramen （β） , the angle between perpendicular of screw insertion point （γ） , and the tangent of in- ner border of lateral mass [δ ： （ β ＋ γ）/2 - β ]. There measurements were performed from the left and right sides and the mean was taken for statistical analysis. [ Result] Parameters L1 ,L2 ,L3 ,α ,β ,γ,and 5 measured from the left and right side by virtual surgery system demonstrated no statistical difference. [ Conclusion ] The five millimeter away to the junctional zone of lateral mass and underside of posterior arch pedical can be chose as screw insertion point. The insertion depth should be ranged 18 - 22 mm, the incline up ranged 18° -20°, and the adduction in sagittal plane 6°

关 键 词：寰椎 侧块螺钉 内固定 虚拟手术系统 

分 类 号：R687.3[医药卫生—骨科学]