前路经寰枕寰枢关节锁定钛板螺钉内固定系统的匹配性研究

Compatible study of anterior occiput to axis transarticular locking plate system

目的观察新型前路经枕寰枢关节锁定钛板螺钉内固定系统与枕颈复合体的匹配性,探讨此内固定系统临床应用的可行性。方法对枕颈部CT扫描数据进行三维重建,并通过数字化模拟手术进行解剖学匹配实验。通过观察钛板枢椎椎体前表面的切合性及螺钉的走行,测量经关节螺钉的理想钉道参数,评估此内固定系统与枕颈复合体的匹配性。结果钛板与枢椎椎体前表面相匹配;经关节螺钉均穿过寰枕关节及寰枢关节进入枕骨髁,无穿出骨质者,螺钉均未损伤舌下神经管。椎体固定螺钉均位于枢椎椎体骨质内,未进入椎管及椎间隙。经关节螺钉钉道理想钉道参数与内固定系统实际钉道参数差异无统计学意义。结论前路经寰枕寰枢关节锁定钛板螺钉内固定系统与枕颈复合体解剖学匹配性较好,具有临床应用可行性。

Objective To investigate the feasibility of anterior occiput to axis transarticular locking plate system through analyzing its compatibility with the occipital cervical complex. Methods Thirty health cases were selected from the date of head-neck CT examination randomly. 3D models of occipital cervical complex were reconstructed on the date. The anatomical compatibility was assessed between the systems and the 30 cases through surgical simulation by computer via digital technology. The morphological compatibility between the titanium plate and the surface of the axis as well as the screw trajectory were observed. The ideal screw trajectory parameters of trans- articular screws were measured so that the compatibility could be assessed. Results There was a morphological match between the titanium plate and the surface of the axis. All the trans-articular screws passed through the atlanto-occipital articulation and the atlanto-axial articulation, without piercing the bones or going into the hypoglossal canal. The fixed screws were in the axial vertebral body without going into the intervertebral space and the spinal canal. There was no significant difference between the ideal screw trajectory and the actual screw trajectory. Conclusions Anterior occiput to axis transarticular locking plate system has a better anatomic compatibility with the Chinese occipital cervical complex. And it is feasible in clinical application.