寰椎椎弓根螺钉置钉的解剖与临床研究

Anatomic and Clinical Study of Pedicle Screw Placement on Atlas

目的:建立和验证寰椎后路椎弓根螺钉固定的进钉技术。方法:利用40套干燥配套寰枢椎标本测量进钉技术的相关参数,而后临床应用该技术方法置钉并行X线、CT复查其准确性。结果:寰椎椎弓根平均宽度为7.8mm,进钉点在寰椎椎弓根中线外侧2.2mm,螺钉进钉点可由经枢椎下关节突中点的纵垂线来确定;手术中该方法不仅能简化操作过程,而且术后检查发现螺钉均准确置入。结论:用枢椎下关节突中点作为术中判定寰椎椎弓根螺钉进钉点的方法准确可靠。

Objective: To establish and verify the technique of posterior pedicle screw placement on atlas. Methods: Forty paired vertebrae of atlas and axis were measured anatomic data relative to the screw placement technique, and using the technique in operation and test the accuracy of the screws with X-ray and CT after surgery. Results: The mean width of the atlas pedicle were 7.78mm; the screw entry point of the present technique were 2.2mm lateral from the central vertical line of the atlas pedicle,and it could be determined by the vertical line through the central point of C2 inferior articular process. In clinical using, the present method not only can simplify the operation but also can insert the screws correctly. Conclusions:The method that using the central point of C2 inferior articular process as a key anatomic landmark for determining the enter point of C1 pedicle screws is accurate and reliable.