前路经寰枢关节螺钉内固定术的解剖学测量及其临床意义

Anatomical measurement and clinical significance of anterior transarticular screw fixation

[目的]为国人前路经寰枢关节螺钉内固定术提供解剖学依据。[方法]在50套中国成人配套干燥寰枢椎标本上,对前路经寰枢关节螺钉内固定术的相关解剖学数据进行测量。[结果]前路经寰枢关节螺钉内固定术以枢椎前弓下缘与枢椎椎体侧缘交界点上方4mm处为进钉点,在矢状面上螺钉植入的最小外偏角为(10.80±2.10)°,最大外偏角为(25.13±3.12)°,冠状面上最小后偏角为(8.85±2.12)°,最大后偏角为(26.96+3.09)°,枢椎正中至枢椎横突孔内侧缘距离为(14.12±1.28)mm,内、外侧钉道长度分别为(17.48±2.10)mm和(25.41±2.59)mm。[结论]前路经寰枢关节螺钉内固定术中,两侧置入螺钉的理想的钉道角度为外偏10°～25°,后倾9°～27°、理想的螺钉长度为17～25mm,由枢椎前缘正中向外分离显露不宜超过14mm。

[ Objective] To provide Chinese morphological data for anterior C1 ,2 transarticular screw fixation. [ Method] With a digital vernier and a goniometer made in China, the anatomic parameters related to anterior C1,2 transarticular screw fixation were measured from 50 pairs of dried Chinese adult human C1 and C2 vertebrae. [ Result] In the anterior transarticular screw fixation, the lateral angulation of the screw tract to the sagittal plane ranged from（ 10.8±2.10）° to （25.13±3.12）° ,the posterior anguation to the coronal plane from （8.85±2.12）° to （26.96±3.09）° ,the screw tract length was from （ 17.48 ±2.1 ） mm to （25.4±2.59 ） mm, the distance from medial part of C2 foramen to the middle of C2 body was （ 14.12±1.28 ） mm. [ Conclusion ] It is optimal for the anterior C1,2 transarticular screw fixation to place the anterior C1,2 transarticular screw with the length of 17 mm to 25 mm in lateral angulation ranged from 10° to 25° and the posterior angulation ranged from 9° to 27°. During the procedure,the dissecting distance from the middle of C2 to lateral should not exceed 14 mm.