前路寰枢椎经关节螺钉内固定应用解剖学研究及初步临床应用

发布时间：2018-05-27 20:55

本文选题：解剖学 + 寰枢关节　；参考：《南华大学》2005年硕士论文

【摘要】：目的对枕寰枢复合体进行应用解剖学研究,为前路寰枢椎经关节螺钉内固定技术提供解剖学依据:并探讨其可行性和评价其初步临床疗效。方法 1、标本测量对30具中国正常人寰枢椎骨标本进行解剖学测量;对5例枕颈部标本进行毗邻结构的解剖学观察。 2、螺钉通道的设计及置钉训练 5例人体标本上模拟手术,并直视下在5例新鲜枕颈部标本上置钉训练。螺钉固定后摄X光片,在X片上测量螺钉通道参数。并在标本截面上测量螺钉通道与椎动脉、脊髓和枕寰关节的距离。 3、临床初步应用应用前路寰枢椎经关节螺钉内固定技术治疗11例寰枢椎失稳患者。结果 1、标本测量结果寰椎侧块外侧壁高度为18.84±0.23mm;侧块内侧壁高度为9.76±0.22mm;侧块宽度为11.03±0.23mm;侧块后1/2前后径长度为10.09±0.14mm。枢椎椎体宽度22.4±1.2mm。螺钉通道的外斜角18°-32。和上斜角21°-30°。 2、螺钉通道的设计及置钉训练 ①术前设计螺钉通道的参数与实际置钉后的参数之间双侧t检验显示两样本均数差异无显著性(P0.05)。②理想的钉道参数是:在矢状面上的上斜角26°;在冠状面上的外斜角25°;钉道长度38.4±1.8mm。③在枢椎横突下缘的截面上,20枚螺钉与椎动脉之间距离最短,为4.7±0.12mm。在枢椎上关节面的截面上,螺钉与椎管内壁之间距离最短,为6.27±0.13mm。螺钉与寰椎侧块上关节面之间距离为2.5±0.14mm。
[Abstract]:Objective to study the applied anatomy of occipito-atlantoaxial complex in order to provide anatomic basis for anterior atlantoaxial transarticular screw fixation. Method 1. The atlantoaxial bone specimens of 30 Chinese normal subjects were measured and the adjacent structures of 5 occipitocervical specimens were observed. (2) the design of screw passage and the training of nailing in 5 cases of human body and 5 cases of fresh occipitocervical specimen under direct vision. The screw was fixed and X-ray film was taken, and the screw channel parameters were measured on the X-ray film. The distance between the screw passage and vertebral artery, spinal cord and occipitocatlantal joint was measured on the cross section of the specimen. 3. 11 cases of atlantoaxial instability were treated with anterior transarticular screw fixation. Result 1. The lateral wall height of lateral mass of atlas was 18.84 卤0.23 mm, the height of lateral wall was 9.76 卤0.22 mm, the width of lateral mass was 11.03 卤0.23 mm, and the length of anterior and posterior diameter of 1 / 2 of lateral mass was 10.09 卤0.14 mm. The width of the axial vertebral body was 22.4 卤1.2 mm. The external angle of the screw passage is 18 掳-32. And the upper angle is 21 掳-30 掳. 2. Design of screw passage and training of screw insertion 1 bilateral t test showed that there was no significant difference in the mean of the two samples between the parameters of the designed screw channel before operation and the parameters after actual nailing. The ideal parameters of the two samples were as follows: in sagittal plane, there was no significant difference in the mean of the two samples. The upper oblique angle is 26 掳, the external slope angle is 25 掳on the coronal plane, the length of the nail canal is 38.4 卤1.8mm.3, and the distance between 20 screws and vertebral artery is the shortest in the section of the inferior edge of the transverse process of axis. It was 4.7 卤0.12mmm. The distance between the screw and the inner wall of the spinal canal was the shortest (6.27 卤0.13 mm) on the cross section of the superior articular surface of the axis. The distance between the screw and the superior articular surface of the lateral mass of atlas was 2.5 卤0.14 mm.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R687.3;R322

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