基于影像学数据设计带融合器的寰枢椎后路内固定系统  

Design for posterior atlantoaxial internal fixation system with fusion cage based on imaging data

作　　者：潘保顺 方镇[1] 高明杰[1] 方贵明[1] 陈金水 Pan Baoshun;Fang Zhen;Gao Mingjie;Fang Guiming;Chen Jinshui(Department of Orthopedics,Third People’s Hospital of Bengbu,Bengbu 233000,Anhui Province,China;First Department of Orthopedics,900 Hospital of the Joint Logistics Team,Fuzhou 350025,Fujian Province,China;First Department of Orthopedics,Clinical Institute of Fuzhou General Hospital,Fujian Medical University,Fuzhou 350025,Fujian Province,China)

机构地区：[1]蚌埠市第三人民医院骨科,安徽省蚌埠市233000 [2]联勤保障部队第九〇〇医院骨一科,福建省福州市350025 [3]福建医科大学福总临床医学院骨一科,福建省福州市350025

出　　处：《中国组织工程研究》2022年第9期1372-1376,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81301602),项目负责人:陈金水;福建省自然科学基金(2016J01581),项目负责人:陈金水;福建省科技计划引导项目(2020Y0077),项目负责人:陈金水;蚌埠医学院自然科学基金(2020byzd380),项目负责人:潘保顺。

摘　　要：背景:国内外有关寰枢椎后路融合器的报道较少,且存在许多不足,缺乏操作方便、植骨区域大、植骨稳定的融合器。目的:依据寰枢椎解剖学特征设计一款带融合器的寰枢椎后路内固定系统,并探讨其可行性。方法:收集100例(男、女性各50例)正常寰椎后弓及枢椎椎板的CT影像学资料,测量寰椎后弓高度及厚度、枢椎椎板斜率、寰椎后弓下缘至枢椎棘上缘突高度、寰枢椎椎间隙高度、两侧寰椎椎弓根外侧缘距离及后结节处至该线的距离并计算后弓外侧缘半径;取后结节旁4 mm处为进钉点,测量后弓螺钉置入长度及螺钉与后弓中线角度。分析解剖参数并设计带融合器的寰枢椎后路内固定系统。结果与结论:①寰椎后弓下缘至枢椎棘突上缘高度为(19.07±2.73)mm,寰枢椎椎间隙高度为(6.83±2.01)mm,枢椎椎板斜率为(58.34±7.60)°,寰椎后弓外侧缘半径为(26.77±2.14)mm,寰椎后结节高度为(10.45±1.61)mm,寰椎后结节厚度为(8.12±1.57)mm,寰椎后弓螺钉置入长度为(11.21±1.61)mm,螺钉与后弓中线角度为(53.34±6.30)°,左侧与右侧数据差异无显著性意义;②依据寰枢椎影像学测量数据成功设计了带融合器的寰枢椎后路内固定系统,并申请获得国家专利,为寰枢椎后路内固定提供新的补充内固定方式。BACKGROUND:The report for posterior atlantoaxial fusion cage is few and there are still many shortages.There is a lack of fusion cages with convenient operation,large bone graft area and stable bone grafting OBJECTIVE:To design a posterior atlantoaxial internal fixation system with fusion cage according to the anatomical characteristics and study its feasibility.METHODS:The imaging data of 100 cases(50 males and 50 females)of normal posterior arch of atlas and axis lamina were collected.The sagittal plane was used to measure the height and the thickness of the posterior arch of atlas,the slope of the axis lamina,the height of the posterior inferior margin of atlas to the upper margin of the axis,and the height of the atlantoaxial intervertebral space.The distance between the lateral margin of the pedicle of the atlas on both sides and the distance from the posterior tubercle to this line were measured to calculate the radius of the lateral margin of the posterior arch.The point which was 4 mm to the posterior tubercle was taken as the nailing point to measure the inserting length of the screw and the angle between the screw and the middle line of the posterior arch.The anatomic parameters were analyzed to design the posterior atlantoaxial internal fixation system with fusion cage.RESULTS AND CONCLUSION:(1)The height from the lower edge of the posterior arch of atlas to the upper edge of the axis spinous process was(19.07±2.73)mm.The height of the atlantoaxial intervertebral space was(6.83±2.01)mm.The slope of the axis lamina was(58.34±7.60)°.The radius of the lateral edge of the posterior arch of atlas was(26.77±2.14)mm.The height of the posterior tubercle of atlas was(10.45±1.61)mm.The thickness of the posterior tubercle of atlas was(8.12±1.57)mm.The inserting length of the posterior arch screw of atlas was(11.21±1.61)mm,and the angle was(53.34±6.30)°.The data difference between the two sides had no statistical significance.(2)According to the measurement of the imaging data,the design of the atlantoax

关 键 词：寰枢椎 影像学 解剖学 CT测量 后路 内固定 融合器 寰椎后弓螺钉 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]