CAJ | 학술논문

目的：通过对成人寰椎尸体标本的解剖学研究和测量，为临床上施行寰椎椎弓根螺钉内固定提供解剖依据。方法对20具健康成人寰椎干燥尸体标本进行解剖学测量，确定寰椎椎弓根螺钉进钉点及置钉角度的相关参数。结果寰椎椎弓根的宽度为（10.62±0.70）mm，进钉点处及椎动脉沟最薄处后弓高度分别为（4.71±0.36）mm和（4.28±0.55）mm，最大进钉长度为（26.91±1.68）mm，钉道内倾角为（3.75±1.42）°，头倾角为（3.25±1.74）°。结论寰椎以后弓和侧块内、外侧缘的移行处连线中点的矢状面与后弓下缘上方2 mm处的冠状面的交点为进钉点，内倾2°～6°、头倾2°～5°进行椎弓根螺钉内固定是安全、可行的。
목적：통과대성인환추시체표본적해부학연구화측량，위림상상시행환추추궁근라정내고정제공해부의거。방법대20구건강성인환추간조시체표본진행해부학측량，학정환추추궁근라정진정점급치정각도적상관삼수。결과환추추궁근적관도위（10.62±0.70）mm，진정점처급추동맥구최박처후궁고도분별위（4.71±0.36）mm화（4.28±0.55）mm，최대진정장도위（26.91±1.68）mm，정도내경각위（3.75±1.42）°，두경각위（3.25±1.74）°。결론환추이후궁화측괴내、외측연적이행처련선중점적시상면여후궁하연상방2 mm처적관상면적교점위진정점，내경2°～6°、두경2°～5°진행추궁근라정내고정시안전、가행적。
Objective To provide accurate anatomic foundation for the insertion of C1 pedicle screw in the operation via anatomic research and measurement on adult′atlas dry specimens. Methods A total of 20 human adult atlas specimens were measured bilaterally to decided the relevant parameters of pedicle screw entry point and the direction of the screw trajectory. Re-sults The width of C1 pedicle was (10.62±0.70)mm. The heights of the posterior arch at the entry point and vertebral artery groove were (4.71±0.36)mm and (4.28±0.55)mm respectively. The longest trajectory distance of the screw path was (26.91±1.68)mm. The leaning angle of trajectory was (3.75±1.42)° and the angle of sagittal view was(3.25±1.74)°. Conclusion The enter point of atlas is the intersection point of sagittal plane ,which is through the midpoint of distance from the junction of C1 posterior arch me-dial and lateral border to lateral mass ,and coronal plane 2 mm superior to the inferior border of posterior arch. When the leaning angle of trajectory is 2°-6° to the coronal plane and 2°-5° cephalad to the transverse plane,it is effective and safe to perform pedicle screw fixation.