寰枢椎椎弓根影像学定位的临床应用研究.docVIP

寰枢椎椎弓根影像学定位的临床应用研究 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：寰枢椎椎弓根影像学定位的临床应用研究 1 1 资料与方法 2 2 结果 4 3 讨论 5 文2：寰枢椎椎弓根影像学测量及临床应用 7 1 资料与方法 8 2 结 果 10 3 讨 论 10 参考文摘引言： 12 原创性声明（模板） 13 文章致谢（模板） 14 正文 寰枢椎椎弓根影像学定位的临床应用研究 文1：寰枢椎椎弓根影像学定位的临床应用研究 【ABSTRACT】 Objective:To investigate the anatomical data for pedical screw fixation for atlas and axis by radiographic measurement and to improve the success rate of putting :The points of putting Screw,obliquity angle of atlantoaxial xray films and CT sca from oct 2001 to sep 2007 were measured by PACs pedicle fixation between atlas and axis for 48 cases with atlantoaxial itability was treated with screwplate system,and bony fusion by selfmade position equipment of puttig screw point of atlas :The safe points of putting screw by atlas pedice should be:left ±，right ±;obliquity angle of putting screw to iide by atlas pedicle:left（±°），right（±）°，obliquity angle of putting screw to front side by atlas pedicle: （±°）;screw point by axis pedicle： left ±，right ±;obliquity angle of putting screw to iide by axis pedicle：left(±)°,right(±)°;obliquity angle of putting screw to the frontside by axis pedicle:(±)°.The average followedup period for 48 cases was to JOA Score standard,31 cases of them were excellent,14 cases was good,2 cases were common,1 case was bad,and the rate of excellent and good results was %.Conclusion:Measurement with xray ,CT sca CR,DRX and MRI has better itruction to screwpalate system by atlantoaxis pedicle,beacuse of simplification of design and method. 【KEY WORDS】 AtlantoAxial Joint,Radiography,CT, 寰枢椎不稳定将使颈脊髓处于高危状态，多数需要手术 治疗 。经椎弓根寰枢椎内固定手术的关键是螺钉能否准确地经椎弓根到达理想的部位，进钉点、入钉角度的准确判断是椎弓根螺钉的核心技术。～月，我们于术前采用自行设计的方案，对200份CR、DRX线片、MRI及64排CT片的影像学资料进行分析，测量个性化定位方案，术中利用自制的寰枢椎椎弓根定位导向器，依据测量数据对48例患者192枚寰枢椎椎弓根行经椎弓根固定手术，收到较好治疗效果，报告如下。 1 资料与方法 一般资料 本组男35例，女13例；年龄22～61岁，平均岁；Ⅱ型陈旧性齿状突骨折22例，齿状突不连12例，横韧带损伤14例。均有寰枢椎不稳或高位颈脊髓病的症状与体征。入院后经1～2周颅骨牵引，患者症状及体征减轻，畸形纠正或基本纠正，寰枢椎复位或基本复位后实施手术。本组病例未行前路松解，均经后路手术。 术前准备 术前常规摄颈椎正