Axis系统治疗下颈椎不稳的解剖研究和临床应用

Axis posterior cervical internal fixation system in lower cervical spine instability

目的 :研究下颈椎侧块的解剖特点 ,评估Axis颈椎后路内固定系统的应用价值。方法 :选 16具成人正常下颈椎防腐标本 ,观察解剖特点 ,探查并测量改良Magerl法进针点和进针角度、深度以及与血管、神经的关系。临床应用Axis系统治疗下颈椎不稳 18例。结果 :改良Magerl法进针点选在术中可视侧块中点内下 1～ 2mm处 ,深度13 2～ 16 4mm ,进针角度分别为矢状面角度 45° ,水平面角度 2 9°。距动脉和神经根的距离分别约为 4 1mm和1 9mm。临床应用 18例 ,平均随访 8个月 ,无并发症 ,15例获骨性融合 ,脊髓功能除 1例无改善外 ,余均有不同程度恢复。结论 :改良进针法更适合于国人。Axis系统适用于各种原因引起的需后路减压的下颈椎不稳。侧块固定有一定风险 ,但只要熟悉解剖特点 ,规范操作 。

Objective:To study the anatomical features of lateral mass in lower cervical spine and evaluate the clinical application of Axis posterior cervical internal fixation system.Method:Anatomical morphology of 16 lower cervical spine specimens were observed.Ameliorative method of the screw prick point,angle and depth was measured and defined.18 cases of lower cervical spine instability of various reasons were treated with Axis posterior cervical internal fixation system.Result:The screw prick point was defined in the medial and lower 1～2mm of the mass center.The arrow angle,horizontal angle and depth of internal fixation screw were 45 degree,29 degree and 13 2～16 4mm respectively.18 patients were followed up for an average of 8 months.There was no complication of artery and nerve injury,and no loosening of the plate and the screw.15 cases obtained bony fusion.Spine injury had recovered partly.Conclusion:The ameliorative prick method is more suitable for Chinese.Axis posterior internal fixation system is suitable for the treatment of lower cervical spine instability. Author′s address\ Department of Orthopaedics,General Hospital of Guangzhou Military Region,Guangzhou,Guangdong,510010