CAJ | 학술논문

目的明确枢椎后路棘突椎板螺钉固定的可行性和技术参数,为临床应用提供参考.方法选取20具枢椎标本,仔细解剖以清楚地暴露椎板和棘突.以棘突基底部为进钉点,双侧平行置入棘突椎板螺钉,通过CT重建测量棘突的宽度、螺钉在横断面上的前倾角度、钉道长度及钉尖与脊髓、椎动脉距离.结果所有螺钉均成功置入,未发现螺钉侵犯椎管、横突孔情况发生.重建CT测量发现棘突椎板螺钉在横断面的前倾角度为76.8°±10.6°;螺钉钉道平均长度为(23.1±3.2)mm,其中上位螺钉钉道长度[(22.9±3.3)mm]稍短于下位螺钉钉道长度[(23.3±3.1)mm],但差异无统计学意义(P＞0.05);螺钉钉尖与脊髓和椎动脉的距离分别为(5.3±1.6)mm和(17.4±3.7)mm.上下位螺钉前倾角度、与椎动脉和脊髓的距离数据略有不同,但差异均无统计学意义(P＞0.05).结论枢椎棘突椎板螺钉固定具有解剖学可行性,也许可以作为枢椎后路固定的一种补充内固定方法.
목적 명학추추후로극돌추판라정고정적가행성화기술삼수,위림상응용제공삼고.방법 선취20구추추표본,자세해부이청초지폭로추판화극돌.이극돌기저부위진정점,쌍측평행치입극돌추판라정,통과CT중건측량극돌적관도、라정재횡단면상적전경각도、정도장도급정첨여척수、추동맥거리.결과 소유라정균성공치입,미발현라정침범추관、횡돌공정황발생.중건CT측량발현극돌추판라정재횡단면적전경각도위76.8°±10.6°;라정정도평균장도위(23.1±3.2)mm,기중상위라정정도장도[(22.9±3.3)mm]초단우하위라정정도장도[(23.3±3.1)mm],단차이무통계학의의(P＞0.05);라정정첨여척수화추동맥적거리분별위(5.3±1.6)mm화(17.4±3.7)mm.상하위라정전경각도、여추동맥화척수적거리수거략유불동,단차이균무통계학의의(P＞0.05).결론 추추극돌추판라정고정구유해부학가행성,야허가이작위추추후로고정적일충보충내고정방법.
Objectives To explore the feasibility and the technical parameters in posterior C2 spinous process laminar screw fixation, and discuss the clinic significance of C2 spinous process laminar screws. Methods Twenty cervical cadaveric spines of C2 were dissected, with care taken to expose the lamina and spinous process. After the entrance point of spinous process screw were determined, posterior C2 spinous process laminar screw implantation was performed under visual control. On the morphologic CT scan,the angle and length of the spinous process laminar screw trajectory and the distance between the tip of the screw and the spinal cord and the vertebral artery were measured. Results The C2 spinous process laminar screws were successfully placed, without impingement of the spinal cord and the vertebral artery. There were little differences between superior and inferior screws in the angle, trajectory length and the distance between the tip of the screw and the spinal cord and the vertebral artery, but without significance (P＞0.05). The placed angles of the screws were 76. 8°± 10. 6° in the axial plane. The distance between the tip of the screw and the spinal cord and the vertebral artery was (5.3+1.6) mm and (17.4 ± 3.7) mm respectively. The trajectory length was (23.1±3.2) mm. Conclusions Posterior C2 spinous process laminar screw fixation is feasible. C2 spinous process laminar screw fixation affords an alternative to standard screw placement for plate fixation and cervical stabilization.