椎动脉的解剖研究及在上颈椎椎弓根置钉中的应用  

Anatomical study on vertebral artety and its application in transpedicle screw fixation for upper cervical vetebrae

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]中山大学附属梅州医院骨四科,广东梅州514031

出　　处：《中国骨伤》2014年第9期772-774,共3页China Journal of Orthopaedics and Traumatology

基　　金：广东省卫生厅基金课题(编号:B2012377)~~

摘　　要：目的:测量上颈椎椎弓根与椎动脉的位置关系,提高上颈椎椎弓根螺钉置入的安全性。方法:成人头颈部尸体标本6具(12侧),解剖椎动脉,测量寰椎椎弓根螺钉进钉点处椎动脉下缘距椎动脉沟底部的距离,枢椎横突孔內缘与椎动脉內缘的距离,横突孔内椎动脉的外径,记录数据并进行统计学处理。结果:寰椎椎弓根螺钉进钉点处椎动脉下缘距椎动脉沟底部的距离为左侧(1.96±0.72)mm,右侧(1.99±0.61)mm,枢椎横突孔內缘与椎动脉外缘的距离为左侧(2.23±0.43)mm,右侧(2.30±0.39)mm,横突孔内椎动脉的外径为左侧(3.03±0.48)mm,右侧(2.98±0.75)mm。结论:除了椎动脉高跨病例外,正确置入上颈椎椎弓根螺钉无损伤椎动脉之虞,椎弓根钉置入时应尽量个体化。Objective： To investigate the relationship of upper cervical pedicle and vertebral artery （VA） location in order to improve the safety of transpedicular screw insertion. Methods ：The vertebral arteries on 12 sides of 6 adult pate cadaverous specimens were dissected. The distance between VA and VA groove at the atlas needling point of transpedicle screw, and the distance between VA and the inner edge of axis cervical foramen, and the VA external diameter in axis cervical foramen were measured respectively. Results：The distance between VA and VA groove was （1.96±0.72） mm on the left and （1.99± 0.61 ）mm on the right at the atlas needling point of transpedicle screw, the distance between VA and the inner edge of axis cervical foramen was （2.23±0.43） mm on the left and （2.30±0.39） mm on the fight,the VA external diameter in axis cervical foramen was （3.03±0.48） mm on the left and （2.98±0.75） mm on the right. Conclusion：It is unlikely to injury VA when the transpedicle screws of upper cervical vertebrae were implanted correctly besides high straddled VA, and the individualization must be performed in the process.

关 键 词：椎动脉 寰椎 枢椎 内固定 解剖 

分 类 号：R687.3[医药卫生—骨科学]