摘要
目的探讨枢椎椎板交叉螺钉技术用于国人内固定的可行性及其技术方法。方法上椎板螺钉在对侧椎板上缘的延续线与该侧椎板中上1/3线的相交处为进钉点,至对侧椎板中下1/3线与关节突的中垂线相交处为出钉点;下椎板螺钉在对侧椎板上缘与该侧椎板中下1/3线的相交处为进钉点,至对侧椎板中下1/3线与关节突的中垂线相交处为出钉点。测量30具成人完整干燥枢椎骨标本,指标为椎板高度(H)、上椎板螺钉钉道长度(D1)、下椎板螺钉钉道长度(D2)、椎板中上1/3厚度(T1)、椎板中下1/3厚度(T2)、椎板上缘角度(A1)、椎板下缘角度(A2)、下位入钉点距椎板中下1/3与对侧椎板下缘延长线交点距离(D3)。结果H、D1、D2、T1、T2、A1、A2、D3值分别为(13.0±1.2)、(26.7±1.3)、(28.7±1.8)、(4.4±0.9)、(6.2±1.3)、(54.0±4.2)、(54.5±2.9)、(0.2±1.3)mm。左右侧比较,各测量指标的差异均没有统计学意义;D2和T2明显大于D1和T1(P<0.01),A1与A 2之间的比较没有统计学差异;椎板高度和厚度的关系呈线性相关。结论本解剖研究和固定方法对W right技术作出了补充和完善,结果提示枢椎椎板交叉螺钉技术可用于成年国人;椎板高度和厚度线性相关,能指导术中不同直径螺钉的选择。
Objective To evaluate the feasibility and the methodology of C2 crossing laminar screws for Chinese people. Methods On the basis of Wright＇s technique, the way to place the 4 crossing laminar screws was designed. 30 dry axes were collected to study the relevant measurements： i.e. the bilateral C2 laminar height （ H）, the length of superior C2 laminar screws （ D1 ）, the length of inferior C2 laminar screws （ 132）, the thickness of superior - median laminar （T1）, the thickness of inferior - median laminar （T2）, the angle between the superior edge and the sagittal plane （A1）, the angle between the inferior edge and the sagittal plane （A2）, the distance （D3） between the inferior laminar screw .entry point and the point of the intersection （ formed by the line of inferior - median laminar and the prolongation of inferior edge of he opposite laminar）. Results The values of H, D1, D2, T1, T2, A1, A2 and D3 averaged respectively （13.03±1.24） mm,（26.71±1.34） mm,（28.68 ±1..81） mm,（4.44 ±0.87） mm,（6.16±1.26） mm,（54.0 ± 4.2） mm, （54.5 ± 2.9） mm and （0.17 ± 1.28 ） mm. There were no significant differences between the values on left and right sides（ P 〉0.05）. D2 and T2 were respectively bigger than D1 and T1 （P 〈 0.01 ）. There was no significant difference between A1 and A2 （P 〉0.05 ）. The laminar height and thickness were of a positive linear correlation. Condusion It is feasible to place C2 crossing laminar screws in Chinese patients. The positive linear correlation between the laminar height and thickness may help to select screws of optimal diameter in the operation.
出处
《徐州医学院学报》
CAS
2008年第6期384-387,共4页
Acta Academiae Medicinae Xuzhou
关键词
枢椎
椎板螺钉
解剖学
内固定
寰枢椎不稳
axis
laminar screw
anatomy
internal fixation
atlantoaxial instability
