内镜引导下经后路上接颈椎螺钉内固定的应用解剖.docVIP

内镜引导下经后路上颈椎螺钉内固定的应用解剖 罗特坚 曾铁功 易德保 屈庆元（邵阳医学高等专科学校解剖学教研室，湖南 邵阳422000） 摘要目的 探讨内镜引导下经后路上颈椎螺钉内固定的应用解剖，为临床经后路C2/3椎弓根螺钉固定术提供解剖学资料。方法 选用干骨28套（C1-7），对其滋养孔的位置、椎弓根等相关数据进行了观察和测量。结果 C2/3的滋养孔距后正中线分别为17.26±7.36和16.05±7.95（mm）；椎弓根的长、高、宽分别为6.18±1.36、8.87±2.22、11.54±3.21（mm），4.95±3.5、7.00±0.97、10.50±4.11（mm）；椎弓根的中轴线与正中矢状切面所构成的夹角分别为43.83°±3.09°和41.53°±3.29°。结论 临床经后路C2/3椎弓根螺钉内固定手术，进螺点可选定在C2/3侧块距其外侧缘5mm、距下关节突下缘8mm处，螺钉进入的延长线与正中矢状切面的夹角应为40°～45°之间，并向头侧倾斜10°为宜，螺钉的长度为24mm-30mm，￠为5mm为佳。 关键词经后路上颈椎螺钉内固定应用解剖 Applied Anatomy of Using Posterior Upper Cervical Spine Screw Fixation by Endoscopy LUO Te-jian, ZENG Tiegong, YI De-bao, QU Qing-yuan. （ Department of Anatomy, Shaoyang Medical College ,Shaoyang Hunan 422000） Abstract【objective】To discuss the applied anatomy of using posterior upper cervical spine screw fixation by Endoscopy and provide materials of human anatomy for using posterior C2/3 Pedicle screw fixation in clinic. 【Methods】Using 28 sets of dried bones, we must observe and test the position of nutrient foramen and related data of Pedicle etc. 【Results】C2/3s nutrient foramen is 17.26±7.36 and 16.05± 7.95 mm distance from posterior median line, the length, height and width of Pedicle are 6.18± 1.36, 8.87 ±2.22, 11.54 ±3.21 mm, 4.95±3.5, 7.00 ±0.97, 10.50 ±4.11 mm. The angles between medial axis and median sagittal section of Pedicle are 43.83?± 3.09? and 41.53±3.2 【Conclusion】Using posterior C2/3 Pedicle screw fixation in clinic, we can choose the side mass of C2/3 that is 5 【基金项目：mm distance from its lateral border and 8mm distance from inferior articular process lower margin as the inlet screw point. The angle between extension cord and median sagittal section is between 40? to 50? , especially leaning 10? to cephalic part. The better thing for the length is 24 to 30mm and ￠is 5 mm. Key words: using posterior, screw fixation, Applied Anatomy 颈椎疾病是骨外科常见病多发病之一，尤其是C2/3不稳定性疾病，临床多见[1]。目前国内外学者对上部颈椎螺钉内固定手术入路、固定方法和相关的解剖学研究有较多报道，经查阅部分文献，经后路颈椎螺钉内固定手术治疗上位颈椎不稳定性疾病能收到较好效果[2、3、4]。但存