头部重心的复位在寰枢脱位手术中的意义.pdf

头部重心的复位在寰枢脱位手术中的意义 Restoration of the head’s center of gravity in management of atlantoaxial dislocation 301 general hospital of PLA Yan’an university affiliated hospital Yuan-zheng Zhang 解放军总医院神经外科 延安大学附属医院神经外科 Head’s center of gravity Pravin Salunke：Congenital atlantoaxial dislocation: a dynamic process and role of facets in irreducibility. J Neurosurg: Spine / August 19, 2011 颅脑重心的投影位于鞍背 The projection of the head’s center of gravity located in the dorsum sellae Central ligature line of C3-4 spine is seen as vertical line of a body. Be parallel to the vertical line of a body, normal head’s center of gravity vertical line extends through the upper cervical spine(C3-4). 颈3-4椎体中央连线作为机体直立垂直线，平行于此线，正常头部重心的 垂直线（铅垂线）落在上颈椎（C3-4 ）脊柱内 常用的测量线及夹角 The usual measuring angles Clivus—canal angle （CCA ） 斜坡延长线与椎体后缘延长线的夹角 前屈150⁰～后仰180⁰。小于150⁰为异常。 Cervico-Medullary Angle （CMA ） 颈髓-延髓角：140°~160 ° 常用的测量线及夹角 The usual measuring angles Occipitocervical angle(OCA) Posterior Occipitocervical angle(POCA) 枕颈角91~102 ° 枕颈后角90~120 ° 常用的颅颈测量线不仅是作为诊断的依据， 也是用于术后评价的依据 Usual measuring lines and angles are not only as a basis for the diagnosis, but also basis in the postoperative evaluation Clivus—canal angle （CCA ） Posterior Occipitocervical angle(POCA) Occipitocervical angle(OCA) Head’s center of gravity vertical line Body’s Vertical line 由于寰枢侧关节的前倾畸形，寰枢滑脱，头部重心向前下方移位， 齿状突后移内陷，造成延颈髓受压的临床症状。这种畸形约占临床病例的80% 。 Forward and downward motion of