寰枢椎经关节螺钉固定的临床解剖学测量  

Anatomic Measurements of the Transarticular Screw Fixation of the A tlantoaxial

作　　者：孔庆毅[1] 李家顺[1] 贾连顺[1] 陈德玉[1] 纪荣明[1] 宋滇文[1] 

机构地区：[1]第二军医大学附属长征医院,上海凤阳路415号200003

出　　处：《中国矫形外科杂志》2002年第13期1328-1330,共3页Orthopedic Journal of China

摘　　要：目的 :测量国人寰枢椎经关节螺钉固定的相关参数 ,明确固定时解剖学允许的最大前脱位程度。方法 :对 2 0套正常成人尸体标本的寰枢椎进行解剖 ,观察枢椎横突孔的形状、椎动脉在孔内的走行情况 ;测量经关节螺钉固定的相应指标。结果 :枢椎横突孔形状各不相同 ,椎动脉的走行也有相应的差异。测量进钉最大角 (53 .78± 4 .2 9)° ;标准角 (42 .84± 2 .42 )°;下限角 (32 .75± 3 .45)°;最小角 (2 6 .0 9± 1 .51 )°;标准角位置的钉道长 (38.81± 0 .85)mm ,最大脱位位置的钉道长 (44.2 0± 3 .0 9)mm ;脱位的移位距离 (8.93± 4 .1 7)mm ;占关节面矢状径的百分比 (50 .0 1± 1 8.2 0 ) %。结论 :寰枢椎经关节螺钉固定植入角的最佳角度为与水平面成 (42 .84± 2 .42 )° ;寰枢椎前脱位程度在一定范围内 ,仍允许经关节螺钉的植入。由于个体差异明显 。Objective: Measurements were done on the atlantoaxial joint to get the parameters of trans articular screw fixation and the anatomic allowed maximum anterior dislocation of the atlantoaxial. Methods: Observations were done on 20 normal adult embalmed cadavers. Some given parameters were measured. Results: The shapes of the axis transverse foramina were variable, and the road of spinal art ery were variable too. The inferior angulation of the horizontal plane was (53.78±4 .29)° in the maximum,(26.09±1.51) ° in the minimum,(42.84±2.42)° in the optimal, (32. 75±3.45 )° in the lower limit, respectively. The corresponding screw path leng th was (38.81±0.85)mm, the maximum screw path length after dislocation was (44.20±3.0 9)mm, the anterior dislocation distance of atlas was(8.93±4.17)mm, ana the ratio of d islocation to the saggital diameter of axis was (50.01±18.20)%. Conclusion: Th e optimal inferior angulation of the screw placement relative to horizontal plane was (42.84±2.42)° . The screw can be inserted when the atlantoaxial anterior dislo cation was in a center degree. Because of the significant body variation, the im portance to the detail preoperative image studies should be attached.

关 键 词：寰枢椎 经关节螺钉固定 临床解剖参数 最大前脱位程度 寰枢关节 

分 类 号：R687.32[医药卫生—骨科学]