寰椎前路锁定加压钢板的设计

Design of locking compression plate through transoral approach

背景:目前缺乏经口咽入路单节段固定治疗寰椎骨折的内固定钢板。目的:结合临床实际需求,系统收集寰椎形态学数据,研制寰椎前路锁定加压钢板。方法:用PACS系统影像工作站及CT自带影像处理工作站,测量96例正常成年人寰椎相关解剖参数,包括寰椎前弓宽度、寰椎前结节高度、侧块长度、寰椎前弓长度、侧块中点高度、寰椎侧块外倾角α、寰椎前弓弧度θ及咽后壁软组织间隙。采用SPSS18.0统计软件对所得数据进行统计分析,提供可靠的形态学数据,根据解剖数据及临床要求设计寰椎前路锁定加压钢板。结果与结论:(1)测得寰椎前弓宽度为(8.85±1.47)mm,寰椎前结节高度为(12.49±2.28)mm,侧块长度为(20.14±1.54) mm,寰椎前弓长度为(39.68±2.29) mm,侧块中点高度为(9.98±1.48) mm,寰椎侧块外倾角α为(13.92±1.90)°,寰椎前弓弧度θ为(147.32±4.53)°,咽后壁软组织间隙为(3.12±0.49) mm;(2)寰椎前路锁定加压钢板成功设计,并获得国家专利;(3)提示寰椎前路锁定加压钢板符合寰椎形态学要求,可用于重建寰椎前弓完整性及恢复寰枢椎复合体高度,有效保留上颈椎结构功能。

BACKGROUND:There is a lack of plate for single-segment fixation through transoral approach to treat atlas fracture.OBJECTIVE:To develop a locking compression plate through transoral approach based on the clinical practice and anatomical data of atlas.METHODS:The anatomic parameters of atlas from 96 normal adults were measured with PACS system and CT image system,including width of anterior arch of atlas,height of anterior tubercle of atlas,length of the lateral mass,length of the atlas,middle height of the lateral mass,the extraversion angle of lateral mass of atlas(α),the radian(θ)of anterior arch of atlas,and inter membrane space.The data were statistically analyzed by SPSS 18.0 software in order to design the locking compression plate through transoral approach.RESULTS AND CONCLUSION:(1)The width of anterior arch of atlas was(8.85±1.47)mm,height of anterior tubercle of atlas was(12.49±2.28)mm,length of the lateral mass was(20.14±1.54)mm,length of the atlas was(39.68±2.29)mm,middle height of the lateral mass was(9.98±1.48)mm,the extraversion angle of lateral mass of atlas(α)was(13.92±1.90)°,the radian(θ)of anterior arch of atlas was(147.32±4.53)°and inter membrane space was(3.12±0.49)mm.(2)The locking compression plate through transoral approach was successfully designed,and obtained national patent.(3)To conclude,the locking compression plate through transoral approach meets the requirement of atlas morphology,not only rebuilds the stability of anterior arch of the atlas,but also restores the height of the atlas complex,and preserves the structure function of the upper atlas effectively.