寰枢椎不稳后路钢丝内固定术相关应用解剖学研究

The Study of the Relevant Applied Anatomy of the Posterior Approach to Treat Atlantoaxial Instability by Wiring Fixation

目的 :研究寰椎水平骨与脊髓的应用解剖学关系 ,为寰枢椎不稳后路钢丝内固定术的安全操作提供参考依据。方法 :( 1)统一摄取 10 3例寰椎标本侧位X线片 ,根据寰椎后结节形态分类 ,并分别测量寰椎后结节正中矢状面的高度和厚度。 ( 2 )测量 189例枕颈部磁共振影像资料寰椎水平的脊髓安全间隙 ,按性别和年龄分别统计结果。结果 :( 1)寰椎后结节前级按形态可分为 3种类型。男性后结节的高和厚明显大于女性的值 (P <0 .0 5 )。 ( 2 ) 6 0岁以下正常人的脊髓安全间隙明显大于 6 0岁以上正常人的间隙 (P <0 .0 5 )。结论 :后路钢丝内固定术治疗寰枢椎不稳 ,将钢丝根据寰椎后结节前缘形态预弯 ,紧贴寰椎后结节前缘由上向下穿过椎管 。

Objective:In order to determine the relations between the relevant applied anatomy of spine and skeleton in the horizontal of atlas to provide safe evidences for the posterior approach to treat atlantoaxial instability by wiring fixation.Method:(1)The 103 specimen postnodes of atlas were classified by the shape of the midmost vertical plane,the altitued and thickness of this plane were measured.(2)The 189 magnetic resonance imaging(MRI)images of craniocervical were classified by sex and age,the secure clearance of spinal cord was measured,too.Result:(1)The shape of postnode can be divided into 3 types,The altitued and thickness of postnode of the male showed much greater than that of the female( P <0.05).(2)The secure clearance of the less than 60 year showed much greater than those older than 60 year( P <0.05).Conclusion:To make the wire that has been bent by the foredge from the top to the base of the postnode and adherence the foredge tightly to treat the atlantoaxial instability is a more safer approach.