[1]林华杰,李启运,徐荣明,等.下颈椎椎板螺钉固定的可行性研究[J].中医正骨,2012,24(12):11-14.
　LIN Hua-jie*,LI Qi-yun,XU Rong-ming,et al.The feasibility study of screw fixation on lower cervical vertebral plate[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(12):11-14.
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下颈椎椎板螺钉固定的可行性研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期数:
2012年12期
页码:
11-14
栏目:
脊柱损伤
出版日期:
2012-12-20

文章信息/Info

Title:
The feasibility study of screw fixation on lower cervical vertebral plate
作者:
林华杰1; 李启运1; 徐荣明2; 刘观燚2; 马维虎2; 孙韶华2; 黄燎原2
1.浙江省宁波市中医院,浙江 宁波 315010;
2.浙江省宁波市第六医院,浙江 宁波 315040
Author(s):
LIN Hua-jie*; LI Qi-yun; XU Rong-ming; LIU Guan-yi; MA Wei-hu; SUN Shao-hua; HUANG Liao-yuan.
*Traditional Chinese Medical Hospital of Ningbo City,Ningbo 315010,Zhejiang,China
关键词:
颈椎 椎板 骨折固定术; 内 解剖学 可行性研究
Keywords:
Cervical vertebrae;  Vertebral plate;  Fracture fixation; internal;  Anatomy;  Feasibility study
摘要:
目的:测量下颈椎椎板的解剖学参数,探讨对国人进行下颈椎椎板螺钉固定的可行性。方法:用游标卡尺和量角器测量20具成人尸体C3～C7标本与下颈椎椎板螺钉进钉技术相关的解剖学数据,包括棘突根部、椎板中部和下关节突中部的椎板高度,椎板上、中、下部的厚度,钉道长度,进钉点至椎动脉及脊髓的距离,椎板轴线与矢状面的夹角。随机抽取100例正常成年人下颈椎CT图像,测量C3～C7椎板的相关解剖数据,包括椎板中部厚度、钉道长度、进钉点至椎动脉的距离、进钉点至脊髓的距离、椎板轴线与矢状面的夹角。结果:20具成人尸体C3～C7节段椎板高度、厚度分别为(10.1±1.8)mm～(19.4±1.3)mm、(3.3±0.4)mm～(6.8±1.1)mm。C3～C7节段钉道长度、进钉点至椎动脉的距离、进钉点至脊髓的距离分别为(27.2±3.4)mm～(30.8±3.2)mm、(29.8±4.0)mm～(32.2±3.5)mm、(5.2±1.2)mm～(7.6±1.5)mm。椎板轴线与矢状面的夹角为(54.1°±9.8°)～(60.0°±9.9°)。C7椎板中部高度、厚度,钉道长度及进钉点至椎动脉、脊髓的距离在下颈椎中最大,依次为(19.4±1.3)mm、(6.8±1.1)mm、(30.8±3.2)mm、(32.2±3.5)mm、(7.6±1.5)mm。C3～C7节段CT图像测量下颈椎椎板中部厚度为(4.4±0.7)mm～(8.0±1.3)mm。C3～C7节段钉道长度、进钉点至椎动脉的距离、进钉点至椎动脉的距离、进钉点至脊髓的距离分别为(25.4±2.5)mm～(28.8±3.0)mm、(27.3±2.4)mm～(30.2±3.1)mm、(5.1±1.1)mm～(7.5±1.2)mm。椎板轴线与矢状面的夹角为(55.3°±10.8°)～(60.3°±10.1°)。结论:对国人进行下颈椎椎板螺钉固定在解剖学上具有可行性,该方法可以作为下颈椎后路固定技术的补充。
Abstract:
Objective:To measure the anatomical parameters of lower cervical vertebral plate,so as to explore the feasibility of screw fixation on lower cervical vertebral plate for Chinese.Methods:The anatomical parameters which related to the screw entry technique of lower cervical vertebral plate were measured in 20 adult cadaveric specimens of C3 to C7 segment by vernier caliper and conimeter.The anatomical parameters included the height of cervical vertebral plate in such region as the root of spinous process,the central region of vertebral plate and the central region of inferior articular process; the thickness of superior,median and inferior parts of vertebral plate; the length of screw path; the distance from screw entrance point to vertebral artery and spinal cord respectively,and the angle between axis and sagittal plane of vertebral plate.CT images of lower cervical vertebrae of 100 normal adults were randomly selected,and the anatomical parameters of vertebral plate of C3 to C7 in CT images were measured,including the thickness of central region of vertebral plate,the length of screw path,the distance from screw entrance point to vertebral artery and spinal cord respectively,and the angle between axis and sagittal plane of vertebral plate.Results:The height and thickness of vertebral plate of C3 to C7 segment of the 20 adult cadavers ranged from(10.1±1.8)to(19.4±1.3)mm and from(3.3±0.4)to(6.8±1.1)mm respectively.The length of screw-path of C3 to C7 segment,the distance from screw entrance point to vertebral artery and spinal cord ranged from(27.2±3.4)to(30.8±3.2)mm,from(29.8±4.0)to(32.2±3.5)mm and from(5.2±1.2)to(7.6±1.5)mm respectively.The angle between axis and sagittal plane of vertebral plate ranged from(54.1°±9.8°)to(60.0°±9.9°).The parameters of C7 vertebral plate as its central height,central thickness,screw-path length and distance from screw entrance point to vertebral artery and spinal cord were the maximum ones compared with those in the lower cervical vertebrae,and they were(19.4±1.3),(6.8±1.1),(30.8±3.2),(32.2±3.5)and(7.6±1.5)mm in order.Central thickness of vertebral plate ranged from(4.4±0.7)to(8.0±1.3)mm in CT images of C3 to C7.The parameters of C3 to C7 as its screw path length,distance from screw entrance point to vertebral artery and spinal cord were(25.4±2.5)to(28.8±3.0)mm,(27.3±2.4)to(30.2±3.1)mm,(5.1±1.1)to(7.5±1.2)mm respectively.The angle between axis and sagittal plane of vertebral plate ranged from(55.3°±10.8°)to(60.3°±10.1°).Conclusion:It is feasible to apply screw fixation on lower cervical vertebral plate for Chinese based on the anatomical parameters,and this method can be used as a supplement to the techniques of posterior lower cervical vertebra fixation.

参考文献/References:

[1] Seichi A,Takeshita K,Nakajima S,et al.Revision cervical spine surgery using transarticular or pedicle screws under a computer-assisted image-guidance system[J].J Orthop Sci,2005,10(4):385-390.
[2] Muffoletto AJ,Yang J,Vadhva M,et al.Cervical stability with lateral mass plating:unicortical versus bicortical screw purchase[J].Spine(Phila Pa 1976),2003,28(8):778-781.
[3] Takayasu M,Hara M,Yamauchi K,et al.Transarticular screw fixation in the middle and lower cervical spine.Technical note[J].J Neurosurg,2003,99(1 Suppl):132-136.
[4] 张丙磊,张强,余枫,等.枢椎椎板螺钉固定的解剖学研究[J].中国脊柱脊髓杂志,2006,16(1):45-47.
[5] 马向阳,尹庆水,吴增晖,等.枢椎椎板螺钉固定的解剖可行性研究[J].中国脊柱脊髓杂志,2006,16(1):48-51.
[6] 胡勇,徐荣明,马维虎,等.枢椎后路椎板螺钉固定技术的可行性研究[J].中国骨伤,2008,2l(8):581-584.
[7] Rath SA,Moszko S,Schäffner PM,et al.Accuracy of pedicle screw insertion in the cervical spine for internal fixation using frameless stereotactic guidance[J].J Neurosurg spine,2008,8(3):237-245.
[8] 曹进,徐荣明,仲肇平,等.C7后路椎板螺钉固定解剖学可行性研究[J].中国骨伤,2010,23(4):282-285.
[9] 胡勇,杨述华,杨操,等.枢椎后路三种螺钉固定技术的定量解剖[J].解剖学杂志,2007,30(1):73-76.
[10] 章庆峻,罗卓荆,李明全,等.颈椎侧块的应用解剖及其在后路钢板螺钉内固定术中的意义[J].中国临床解剖学杂志,2003,21(1):19-21.

备注/Memo

备注/Memo:
基金项目:浙江省宁波市科学技术局自然科学基金项目(2010A610061)
通讯作者:徐荣明 E-mail:lhjnbly@126.com
更新日期/Last Update: 2012-12-20