摘要
目的:探讨下颈椎后路经关节突关节椎弓根螺钉固定的可行性和技术参数,为临床应用提供参考。方法:取20具颈椎标本,仔细解剖颈部的后侧和前侧方,清楚显露颈椎侧块和椎弓根。以侧块外下象限的中心点为进钉点,从C3/4～C6/7直视下经关节突关节置入椎弓根螺钉,通过CT重建,测量经关节突关节椎弓根螺钉内固定进钉角度和钉道长度。结果:经关节突关节椎弓根螺钉均成功置入,螺钉固定方向在矢状面呈尾倾,冠状面呈内倾,理想角度为在矢状面尾倾50.3°±4.9°,在冠状面内倾42.8°±4.0°。螺钉钉道长度为(34.1±1.4)mm,各固定节段间略有不同,但差异无统计学意义(P>0.05)。结论:下颈椎后路经关节突关节椎弓根螺钉固定是可行的,但置钉时要求较高的准确性,可以作为颈椎侧块螺钉和椎弓根螺钉固定的一种补充方法。
Objective：To study the the feasibility and the technical parameters in posterior transarticular pedicle screw fixation,and to discuss the clinic significance of transarticular screws in the lower cervical spine.Method：Twenty cadaver cervical spines were dissected ,with care taken to expose the lateral masses and pedicles.After the entrance point of transarticular pedicle screws was determined,transarticular pedicle screws were inserted posterior under visual control from C3/4 to C6/7.Then the angle and the length of the transarticular pedicle screw were measured from the reconstruction image of CT scan.Result：For a successful screw insertion,the trajectory of the cervical transarticular pedicle screw must tilt caudally in the sagittal plane and laterally in the axial plane.The ideal insertion angles of the screws were 50.3°±4.9° in the sagittal plane and 42.8°±4.0° in the axial plane.The ideal length of the trajectory was（34.1±1.4）mm.There was a little bit difference in the measuring data from different cervical vertebrae,but no statistical significance was found（P〉0.05）. Concinsion：Posterior transarticular pedicle screw fixation is feasible,but the trajectory of the screws must be strictly determined.Transarticular pedicle fixation in the lower cervical spine can be an alternative to standard screw placement for plate fixation and cervical stabilization.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第7期539-542,共4页
Chinese Journal of Spine and Spinal Cord
基金
宁波市社会发展攻关项目(项目编号:2006C100061)
关键词
颈椎
内固定器
解剖学
经关节突关节
椎弓根螺钉
Cervical vertebrae ： Internal fixators
Anatomy
Transarticular
Pedicle screws
