椎动脉Ⅴ3段的解剖研究及在寰枢椎椎弓根置钉中的应用  

Anatomical study of vertebral artety Ⅴ3 segment and its application in transpedicle screw fixation of atlas and axis

作　　者：武兴国[1] 黄健[1] 蒋煜青[1] 郭伟康[1] 王军[1] 

机构地区：[1]广东省梅州市人民医院骨四科,514031

出　　处：《中国骨与关节损伤杂志》2014年第7期636-638,共3页Chinese Journal of Bone and Joint Injury

基　　金：广东省卫生厅立项资助项目(B2012377)

摘　　要：目的为临床置入寰枢椎椎弓根钉如何避免损伤椎动脉寻找解剖学依据。方法成人头颈部尸体标本10具20侧,解剖观察椎动脉V3段走行特点并研究其相对寰枢椎椎弓根的空间位置关系。结果椎动脉V3段在椎动脉沟内走行时,椎动脉与椎动脉沟底部距离从外向内逐渐增大,最窄处为椎动脉沟外缘,此处与相应椎动脉下缘的距离为(1.46±0.98)mm,距中线为(20.45±2.19)mm。寰椎椎弓根钉进钉点处椎动脉下缘距椎动脉沟底部的距离为(1.99±0.85)mm。枢椎横突孔內缘与椎动脉內缘的距离为(2.3±0.4)mm。发现寰枢椎椎弓根处VA变异不适合置钉者各一侧。结论大部分寰枢椎椎弓根钉进钉点是安全的,但由于寰枢椎发育及椎动脉V3段变异并不少见,椎弓根钉置入时应尽量个体化。Objective To provide anatomy evidence to avoid injury of vertebral artery （VA） in the operation of transpedicle screw fixation of atlas and axis. Methods The course characteristic of VA V3 segment and its position relation with pedicle of atlas and axis on 20 sides of 10 adult pate cadaverous specimens were studied. Results The distance between VA and YA groove increased gradually from outside to inside ,the most narrow place was located at the exterior margin of VA groove, its distance to VA was （1.46±0.98）mm, its distance to the median line was （20.45±2.19）mm. At the atlas needling point of transpedicle screw ,the distanee between VA and VA groove was （1.99±0.85）mm. The distance between VA and the inner edge of axis cervical foramen was （2.3±0.4）mm. Each side variation of VA adjoined transpedicle of atlas and axis were found. Conclusion Bulk needling point of transpediele screw of atlas and axis is safe, considering the variation of VA is not scarce, individualization should be performed in the operation of transpedicle screw fixation of atlas and axis.

关 键 词：椎动脉 寰枢椎 内固定 解剖 

分 类 号：R687.3[医药卫生—骨科学]