颈椎侧块的形态学测量及其在临床上的应用  

Measurement of Cervical Lateral Mass and Its Clinical Significance

作　　者：吉立新[1] 宋祥平[1] 黄海[1] 

机构地区：[1]山东省临沂市人民医院骨科医院脊柱外科,276005

出　　处：《中华解剖与临床杂志》2000年第4期207-208,共2页Chinese Journal of Anatomy and Clinics

摘　　要：目的:通过对成人颈椎侧块干骨标本的形态学测量,选择安全、稳定的进钉途径。方法:测量颈椎侧块上关节面与水平面的夹角;侧块上关节面的长径、前后径;侧块上关节面长径与矢状面的夹角、神经根通道与矢状面的夹角;侧块高度。结果:侧块上关节面与水平面的夹角C_3～C_6数值较为接近(48.4±8.3～53.2±5.9),C_7数值较大(62.7±5.4);侧块上关节面的长径C_3～C_7逐渐增大(10.7±1.0～12.0±1.2),成线性关系;前后径C_(3-6)数值接近,C_7最短;侧块上关节面长径与矢状面的夹角48.8±4.6～50.0±3.7;神经根通道与矢状面的夹角59.4±5.5～62.9±4.7。结论:经颈椎侧块内固定,理论上的最佳进钉途径应当是与侧块上关节面长径平行,钉长不宜超过12mm,进钉点应靠近侧块的内侧缘。保持以上进钉角度和进钉深度不会伤及神经根和椎动脉,Objective: To find a safe and secure approach for screw fixation by morphological measurment of cervical lateral mass of adults. Methods: Values of lateral masses were measured from C3 to C7 including the angles between uparticular facet of lateral masses and horizontal, the long diameter and occipitofrontal diameter of uparticular facet of lateral mass, the angles between long diameter of uparticular facet of lateral mass and sagittal plane, the angles between the path of nerve roots and sagittal plane, and the height of lateral masses. Results: The values if angles between uparticular facet and horizontal similar from C3 to C6(48. 4 ± 8. 3 - 53. 2 ± 5. 9), but greater for C7(62.1 ± 5. 4). The length of long diameter of uparticular facet is increased gradually and shows linear relations from C3 to C7(10. 7 ± 1.0 - 12. 0 ± 1.2). The occipitofrontal diameters of uparticular facet of C7 is the smallest in all the lateral masses measured and the others are similar. The angles between long diameter and sagittal plane range from 48. 8 ± 4. 6 to 50. 0 ± 3. 7 and the angles between the path of nerve roots and sagittal plane range from 59. 4 ± 5.5 to 62. 9 ± 4. 7. Conclusion: The best approach for screws entry should be parallel to the long diameter of uparticular facet,but the length of screw should not esceed 12mm. The spot from where the screws entere must be close to the medial border of the lateral masses in order to avoid injury of nerve root and vertebra artery.

关 键 词：颈椎侧块 形态学测量 临床应用 内固定 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]