摘要
目的:为寰椎侧块后路螺钉固定提供解剖学依据。方法:对３０例中国成年人的寰椎干骨标本具有临床意义的数据进行解剖学测量,同时对６例新鲜颈椎尸体标本的后人路颈２神经根与寰椎侧块的关系进行观察。结果:寰椎中线至侧块中点、椎动脉内侧壁、椎弓根内缘的距离分别为:(１７．５６±１．１８)ｍｍ、(２３．０４±１．６９)ｍｍ及(ｌ４．１８±１．０７)ｍｍ;侧块中部的宽度为(１１．５９±１．３９)ｍｍ,侧块中心点的厚度为(１２．７０±１．０４)ｍｍ;后弓与侧块移行处中点至下关节面间距为(４．０８±０．６９)ｍｍ;椎动脉沟处后弓厚度为(４．７０±１．００)ｍｍ。解剖学观察见颈２神经根出脊髓后沿颈１/２关节间隙的下方向外下行走,且颈２神经根有较大的移动度。结论:寰椎侧块较枢椎椎弓根明显宽大,颈２神经根的上方有足够的空间,故认为寰椎侧块后路螺钉固定是完全可行的。螺钉的进钉方向矢状面应向上２０°,横断面上应向内斜１５°,螺钉在侧块内的长度约２２ｍｍ。
Objective:To provide the anatomic basis for the posterior screw fixation on the lateral mass of atlas. Methods: Thirty atlas specimens of native adults were used to measure the significant clinic data.The relationship of C2 nerve and the lateral mass of atlas were observed on six fresh specimens of upper cervical. Results: The distances from the middle line to midpoint of lateral mass, to the inner wall of transverse foramen and to the inner edge of pedicle were 17.56±1.18 mm, 23.04±1.69 mm and 14.18±1.07 mm respectively. The distance from the midpoint in the cross line of posterior arch and the lateral mass to the edge of inferior joint was 4.08 ±0.69 mm. The width of posterior arch in the point of vertebra artery overpass was 4.70 ±1.00 mm. The observation on the fresh specimens showed that the C2 nerve went down lateral beneath the C1,2 joint and it could be pulled. Conclusions: The width and height of the atlas lateral mass are larger than that of the axial pedicle and there is enough space to insert the screw in the atlas lateral mass over the C2 nerve. It is quite possible to insert a screw in the atlas lateral mass. The direction of screw should be about 20°anteroposterior in the vertical plane and 15°inward in the horizontal plane. The suitable length of screw should be about 22 mm inside the lateral mass.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2002年第2期83-85,共3页
Chinese Journal of Clinical Anatomy
关键词
寰椎
内固定
临床解剖学
atlas
internal fixation
clinic anatomy
