下颈椎椎板螺钉固定可行性解剖学研究  

Anatomical study about the feasibility of cervical vertebral lamina screws

作　　者：张伟 付晓玲[2] 吴凯[2] 陈伟高[2] 吴庆[2] 

机构地区：[1]新余钢铁医院骨科,江西新余338000 [2]南昌大学第二附属医院骨科,南昌330006

出　　处：《重庆医学》2014年第6期681-683,共3页Chongqing medicine

基　　金：江西省卫生厅科技计划资助项目(20131061)

摘　　要：目的：探讨下颈椎（C3～C7）椎板螺钉技术用于成人后路颈椎内固定的可行性。方法取9具甲醛溶液固定湿润成人下颈椎标本，其中男6具，女3具，年龄38～63岁，平均51．9岁，平均身高165．6 cm。测量C3～C7椎板厚度（T）、高度（H）、椎板长度（L1、L2）以及椎板长轴和矢状面的夹角（A ）。结果成年男性C3～C7椎板的 T、H、L1、L2较成年女性大，不同性别间的椎板 T、H、L1、L2比较，差异有统计学意义（ P＜0．05），同性别左、右侧之间差异无统计学意义（ P＞0．05）；C3～7平均 T为4．70、3．87、3．30、3．84、5．16 mm ，所测 T大于4．00 mm占54．4％；C3 T大于4．00 mm占77．8％，C4 T大于4．00 mm占61．1％，C6 T大于4．00 mm占33．3％，C7椎板厚度大于4．00 mm占88．9％。结论下颈椎交叉椎板螺钉在解剖学上是可行的，能够在直视下操作，可准确估计钉道的长度以及进钉角度，可用于解剖异常患者，及在其他固定模式失败时作为替代方式。Objective To investigate the feasibility of the lower cervical spine （C3 -C7 ） laminar screw technique for fixing adult posterior cervical spine .Methods We chose 9 formalin fixed moist adult cervical specimens ,which consist of male 6 and female 3 of the age 38 to 63 years old .The average age is 51 .9 years old and the average height is 165 .6 cm .Then we measured the thickness and heightof C3 -C7 lamina ,the lamina length of L1 ,L2 ,and the lamina of axis and the sagittal plane angle .Results The thickness and height of C3 -C7 lamina ,and the lamina length of L1 and L2 of adult male is bigger than adult women .There was statistical sig-nificance between the thickness ,height ,lamina length difference of different genders lamina （P 0 .05） .The average lamina thickness of C2 ,C3 ,C4 ,C5 ,C6 ,C7 were respectively 4 .70 ,3 .87 , 3 .30 ,3 .84 and 5 .16 mm .The lamina thickness which was more than 4 .00 mm accounted for 54 .4% .The lamina thickness of C3 , C4 ,C6 ,C7 which was more than 4 .00 mm accounted respectively for 77 .8% ,61 .1% ,33 .3% ,and 88 .9% .Conclusion Crossing laminar screws in cervical spine is feasible in anatomy .The operation can make under direct vision ,and can accurately estimate the screw path length and entry angle .Patients with anatomic abnormalities can be used as an alternative fixation technique or as fixed in the fixed mode fails .So the results can provide a reference for clinical application .

关 键 词：内固定器 解剖学 下颈椎 椎板螺钉 

分 类 号：R687.3[医药卫生—骨科学]