前路经寰枢关节螺钉内固定术的临床解剖学研究

Clinical anatomic study of anterior C_(1～2) transarticular screw fixation

目的:为前路经寰枢关节螺钉内固定术提供临床解剖学依据。方法:在100对中国成人干燥寰枢椎配对标本上,对与临床前路经寰枢关节螺钉内固定术相关的数据进行解剖学测量。结果:前路经寰枢关节螺钉内固定术冠状面上螺钉植入最小外偏角(5.5±2.0)°(0°～13.0°),最大外偏角(23.6±2.1)°(17.5°～32.5°),矢状面上螺钉植入最小后倾角(14.9±2.6)°(9.0°～27.0°),最大后倾角(25.6±2.5)°(17.5°～33.5°),内侧钉道距离(16.58±1.49)mm(13.78～21.86mm),外侧钉道距离(26.44±1.75)mm(21.81～33.78mm)。结论:前路经寰枢关节螺钉内固定术,16～26mm长度的螺钉,外倾5°～23°、后倾15°～26°方向拧入是安全的。

Objective： To provide anatomic data for anterior C1-2 transarticular screw fixation. Mothods： Direct measurements were taken from lb0 pairs of dried human C1 and C2 vertebrae. The anterior C1-2 transarticular screw insertion point was at the junction of the lateral edge of the C2 vertebral body to 4 mm above the inferior edge of the C2 anterior arch. The parameters related to anterior transarticular atlantoaxial screw fixation were measured. Results： The minimal lateral deflection angle of the screw placement on coronal plane was about （5.5±2.0）°（0°～13.0° ）, and the maximal lateral deflection angle about （23.6±2.1）° （17.5°± 32.5° ）on average. The minimal posterior tilt angle of the screw placement on the saggital plane was about （ 14.9±2.6）°（9.0°～27.0° ）, and the maximal posterior tilt angle about （25.6±2.5）°（ 17.5°～33.5° ） on average. The length of the medial screw path was about （16.58±1.49）mm （13.78～21.86 mm）, and the length of the lateral screw path （26.44±1.75）mm （21.81～33.78 mm）on average. Conclusions： An anterior transarticular atlantoaxial screw with the length of 16-26 mm, the lateral deflection angle of 50-23° on coronal plane, and posterior tilt angle 15-26° on sigittal plane is safe for inserting.