脊 柱 专工 题.docVIP

脊 柱 专 题 The Positioning Study of Cervical Vertebra Lateral Mass Point for Internal Fixation by CT Image Reconstruction Trauma and Orthopaedics Department, People Hospital, Peking University, Beijing, 100044,China. ZHANG Dian-ying, XUE Feng, ZHANG Pei-xun, FU Zhong-guo, JIANG Bao-guo Objective To measure the diameter data of C3～C7 and provide screw tilt angle for clinical cervical vertebra lateral mass internal fixation。 Methods 30 Chinese people were chosed to be subjected to high-speed spiral CT measurement to get the data of C3～C7, and the morphology were reconstructed。 Results Reconstructed CT image data displayed that: 6.98～19.11° outward declination and 54.07° uptilt declination were the best choice for safely procedure of C3；7.75～18.16° outward declination and 48.67° uptilt declination were the best choice for safely procedure of C4；7.17～18.48° outward declination and 44.98° uptilt declination were the best choice for safely procedure of C5；10.78～21.10° outward declination and 48.67° uptilt declination were the best choice for safely procedure of C6；17.44～20.68° outward declination and 49.11° uptilt declination were the best choice for safely procedure of C7。There were no statistical difference between the right side and the left side,but there were statistical difference between man and woman。 Conclusion Reconstructed CT image can provide useful data for clinical cervical vertebra lateral mass internal fixation。 齿状突骨折合并多发伤的诊疗策略 天津医院脊柱外科 白剑强 夏群 胡永成 目的 合并脊柱骨折的多发伤在国内外多有报道。齿状突骨折是颈椎的常见骨折, 占脊柱骨折的1 %～2 % , 占颈椎骨折的10 %～14 % , 该类患者致伤机制复杂，合并伤严重而凶险，易发生漏诊或延迟诊断，伤势危笃常威胁患者的生命，这类伤势的高危性正逐渐受到重视。合并齿状突骨折的多发伤诊疗则在国内外鲜有报道，本文通过一组临床资料来探讨齿状突骨折合并多发伤的临床诊断特点及治疗方法。 方法 回顾性分析2004年4月至2006 年11月12例齿状突骨折并多发伤患者临床及影像学资料。男10例，女2例，年龄21-43岁，平均31.3岁。合并伤：本组患者齿状突骨折合并四肢骨折6例，合并多发肋骨骨折血气胸2 例，合并腹腔脏器损伤及四肢骨折1例,合并颅脑外伤1 例，合并颈2、3骨折1例。ISS评分16 分者4例，16 分者7例, 25 分者1例；2处损伤者5例，3处损伤者6例，4 处损伤者1 例。均行颈椎张口位及CT检查，结合病史、查体确诊。治疗：注意全身情况，确保生命体征平稳：优先处理