国人枢椎侧方椎弓内固定的解剖学基础.docVIP

国人枢椎侧方椎弓内固定的解剖学基础 作者：侯黎升， 贾连顺，谭军，阮狄克，叶晓健，王人鹏 【关键词】 ,脊柱 　　【Abstract】 AIM: To provide the anatomical basis for lateral arch screw fixation in C2 vertebra of Chinese. METHODS: Fiftyseven dry C2 vertebra of Chinese were measured. RESULTS: The parameters obtained of anterior portion of lateral arch were (including Left/Right): Medial inclination from superior view ［ αs = (38±8)°/(40±8)°］, superior inclination ［γ = (63±9)°/(62±8)°］, and the superior, middle and inferior width ［bs = (7.4±1.7) mm/(6.9±1.7) mm, bm = 5.2±1.4 mm/5.2±1.4 mm. bi = (4.2±1.1) mm/(4.2±1.0) mm］, height of superior articular process ［dsa = (2.1±0.9) mm/(2.0±0.9) mm］, superior and inferior height ［hup=(5.1±1.4) mm/(5.0±1.4) mm, hip=(6.1±1.5) mm/(5.8±1.2) mm］. Other parameters were (including Left/Right ): Horizontal distance from standard screw entrance point (O) to lateral edge of inferior articular process ［lla= (4.2±1.2) mm/(3.9±1.1) mm］, posterior edge of superior articular process ［los= (6.4±1.5) mm/(5.0±1.5) mm］ and midposition of isthmus on superior aspect ［loi = (4.4±1.3) mm /(2.6±1.3) mm］, and vertical distance from O to inferior edge of inferior articular process ［hia=(9.4±1.6) mm/(9.4±1.8) mm］. bm in 26 （45.61%）left and 27（47.37%）right sides was less than 5.00 mm. If set αs as medial inclination of lateral screw insertion, 36 left screws and 40 right ones would penetrate into the corresponding side of anterior structure of C2 vertebra, and if set γ as superior angle, all screws would violate the superior facet of axis. CONCLUSION: Neither αs nor γ can guarantee safe and applicable screw insertion of lateral arch. If set 5.0 mm width of middle part of anterior portion of lateral arch as the technical difficult limit, almost one half of C2 vertebra will not be suitable for 3.5 mm screw insertion. 　　【Keywords】 vertebra; lateral arch; internal fixation; anatomical measurement 　　【摘要】 目的： 对国人枢椎侧弓进行应用解剖学测量,为临床行侧弓螺钉植入提供依据. 方法： 用游标卡尺和量角器测量57例干燥