枕骨髁螺钉固定的三维解剖学研究  

A three-dimensional anatomic study on placement of occipital condyle screws

作　　者：杨文玖[1] 邹云雯[1] 褚言琛[1] 王进[1] 杨慧英[1] 侯庆先[1] 李学森[1] 

机构地区：[1]青岛大学医学院附属医院骨科,266071

出　　处：《中华创伤骨科杂志》2013年第1期45-49,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 在尸体标本上评估忱骨髁螺钉置入的安全性与可行性，为临床应用提供理论依据。方法 在10具尸休左、右两侧枕骨髁上分别置入直径为3．5mm、长度为20．0mm的螺钉，操作后行尸体枕颈部CT扫描并进行三维重建。在三维CT图像上测量枕骨髁螺钉与椎动脉、脊髓、舌下神经管等周围重要组织的关系，并测量螺钉长度、上倾角、内倾角、螺钉与舌下神经管的距离及进针点与枕骨髁内侧啭的距离。结果 10具尸体共20侧枕骨髁均成功置入螺钉，三维CT承建后枕骨髁螺钉化置均满意，未伤及脊髓、神经根、舌下神经及椎动脉。左、右侧枕骨髁螺钥‘的平均长度分别为（20．96±0．87）、（20．59±0．54）nlill，平均上倾角分别为11．24°±0．71°、11．11°±0．61°，平均内倾角分刖为31．00°±1．59°和30．85°±0．97°，枕付髁螺车钉与舌下神经管的距离平均分别为（4．84±0．52）、（4．70±0．27）mm，进钉点与枕骨髁内侧壁的距离平均分别为（5．13±0．79）、（5．04±0．68）mm。结论 在一定范围内，枕骨髁可以置人螺钉固定，且不损伤周围神经、血管结构，枕骨髁螺钉。置入固定技术，可作为传统枕颈融合手术方法法的改进或补充。Objective To evaluate the safety and feasibility of implanting occipital condyle screws in cadavers. Methods Screws ot＇ 3.5 mm in diameler and 20.0 mm in length were implanted into the amhilateral occipital condyles in 10 cadaveric specimens. CT scanning was performed after the procedure on the occit）itocervica] region tor tin＇ee-dimensinnal reconstruction of the region. In the three-dimensinnal occip- ilocervical models, relationships between the nccipital condyle screw and its important surrounding tissues, like vertebral artery, spinal cord and hypnglossal canal, were measured. The length, upper and inside tihing angles of the screw, and distances between the screw and the hypoglossal canal and belween the condylar enlry point an（l the medial wall of the occipital condyle were also measured. Results Three-dinmnsional re- construe.finn models showed that all the uccipital condyle screws were successfully implanted into the 20 oc- cipital condyles in 10 cadaveric sl）ecirnens. There was no injury to the spinal cnrd, nerve mot, hypoglnssal nerve or verlehral artery. At the left occipital bone, the average length, upper tilting angle and inside tilting angle of the condylar screws were respectively 20.96 ± 0.87 mm, 31.00°± 1.59°anti 11.24° ± 0.71 °; the dislanccs averaged 4.84 ± 0.52 mm hetween the condylar screw and the hypogtossal canal and 5. 13 - 0.79 nun between the condylar entry point and the medial wall of the occipital condyle. At the right occipital bone, the average lengdl, upper tilling angle and inside tilting angle of the condylar screws were respectively 20.59±0.54 rain, 30.85°± 0.97°and 11. 11 °±0.61°; the distances averaged 4.70±0.27 mm helween the condylar screw and the hypogh）ssal canal and 5.04 ± 0.68 mm between the condylar entry point and the medial wall of the occipital condyle. Conclusions A surgeon who is familiar with the anatomy and skillful in operation （：an use nccipitat cnndyle sc.rews in occipitocervical fusinn without any injury to the iml）nrtant su

关 键 词：成像 三维 脊柱融合术 解剖学 

分 类 号：R687.3[医药卫生—骨科学]