下颈椎经前路椎弓根置钉的应用解剖学研究
Applied anatomic studies of cervical anterior transpedicular screw fixation
目的 为下颈椎前路椎弓根螺钉内固定技术(anterior transpedicular screw fixation, ATPS)的推广提供相关应用解剖学参数。 方法 随机选取30例成人正常颈椎CT影像学资料,将扫描数据导入MIMICS 13.0软件,测量C3~7椎体相关解剖学参数及颈前路椎弓根内固定(ATPS)的置钉参数,并统计分析。 结果 得到选择最佳进钉点及通过最佳进钉通道所测得的置钉参数。经测量得出,C3~7椎弓根的高度要大于宽度,可以容纳最大直径4.5 mm的螺钉,进钉长度可达30 mm。 结论 ATPS作为一种新的内固定技术可以应用于下颈椎疾患的治疗中。对某些颈椎疾患如肿瘤、严重骨质疏松及颈椎三柱损伤等疾患的治疗,可能提供更好的帮助。
Objective To provide relevant anatomic parameters for the promotion of the Cervical anterior transpedicular screw fixation(ATPS). Methods 30 sets adult normal cervical specimens were randomly selected, and the scanned data were imported to the MIMICS 13.0 software;the related anatomical parameters and the pedicle screw parameters of ATPS were measured. Then the obtained data were subject to statistical anylysis. Rusults Through measurement the pedicle screw parameters, the best enterance point for screws and the best enterance channel for the screw could be determined. It could be found from the measurement that the height of the cervical vertebral pedicle was larger than the width and the the largest screw it can contain was 4.5 mm in diameter 30 mm in length. Conclusion ATPS can be applied to the treatment of cervical vertebra disease as a new fixation technology. It may provide a better help for the treatment of some cervical vertebral disease, such as tumor, serious osteoporosis and three-column injury of the cervical spine.
Cervical vertebrae / Anterior / Anatomy / Pedicle / Screw fixation
[1] Abel R, Ruf S, Spahn B. Cervical spinal cord injury and degluti-tion disorders[J].Dysphagia, 2004, 19(2):87-94.
[2] Barsa P, Suchomel P. Factors affecting sagittal malalignment due to cage subsidence in standalone cage assisted anterior cervical fusion
[J].Eur Spine J, 2007,16(9):1395-1400.
[3] Kouyoumdjian P, Gille O, Aurouer N, et al. Cervical vertebral osteoradionecrosis:surgical management,complications and flap coverage- a case report and brief review of the literature[J].Euro Spine J, 2009,18( Suppl 2):S258-S264.
[4] Koller H,Hempfing A,Ferraris L, et al. 4-and 5-level anterior fusions of the cervical spine: review of literature and clinical results
[J]. Eur Spine J, 2007,16(12):2055-2071.
[5] Ning X,Wen Y, Xiao-Jian Y, et al. Anterior cervical locking plate-related complications; prevention and treatment recommendations
[J].Int Orthop, 2008,32(5):649-655.
[6] Koller H, Hempfing A, Acosta F,et al. Cervical anterior transpedicular screw fixation. Part I: Study on morphological feasibility, indications, and technical prerequisites
[J].Eur Spine J, 2008,17(4):523-538.
[7] 李严兵,张韶辉,谢叻, 等. 颈椎椎弓根进钉通道、进钉点与椎体外侧面三维关系定位分析
[J].中国骨科临床与基础研究杂志, 2010, 32(2):29-34.
[8] Abumi K, Kaneda K, Shono Y,et al. One-stage posterior decompression and reconstruction of the cervical spine by using pedicle screw fixation systems.
[J].J Neurosurg, 1999, 90(1 suppl):19-26.
[9] Maat GJ, Matricali B, van Persijn van Meerten EL, Postnatal development and structure of the neurocentral junction. Its relevance for spinal surgery
[J].Spine,1996, 21(6):661-666.
[10] Abumi K, Itoh H, Taneichi H, et al. Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine:description of the techniques and preliminary report
[J]. Spinal Disord ,1994,7(1):19-28.
[11] Jeanneret B, Gebhard JS, Magerl F. Transpedicular screw fixation of articular mass fracture-separation: results of an anatomical study and operative technique
[J]. Spinal Disord ,1994, 7(3):222-229.
[12] Jones EL, Heller JG, Silcox DH, et al. Cervical pedicle screws versus lateral mass screws. Anatomic.feasibility and biomechanical comparison
[J]. Spine, 1997, 22(9):977-982.
[13] 王东来,唐天驹,黄士中,等.下颈推稚弓根内固定的解剖学研究与临床应用
[J].中华骨科杂志,1998,18(4):659-662.
[14] Panjabi MM,Shin EK,Chen NC,et al. Internal morphology of human cervical pedicles
[J]. Spine, 2000, 25(10):1197-1205.
[15] Kosmopoulos V, Schizas C. Pedicle screw placement accuracy: a meta-analysis
[J]. Spine, 2007, 32(3):111-118.
[16] Isu T,Minoshima S,Takeda M,et al.A surgical technique for a vertebral column autograft using the intervertebral disc for cervicaldisc disease
[J].Acta Neurochir(Wien),1998,140(3):267-273.
[17] Kantelhardt SR, Oberle J, Derakhshani S, et al. The cervical spine and its relation to anterior plate-screw fixation: a quantitative study
[J].Neurosurg Rev, 2005, 28(4):308-312.
[18]Kotani Y, Cunningham BW, Abumi K, et al. Biomechanical analysis of cervical stabilization systems. An assessment of transpedicular screw fixation in the cervical spine
[J].Spine ,1994,19(22):2529-2539.
[19] 王东来,唐天驷,黄世忠,等. 五种颈椎内固定方法的稳定性生物力学评价
[J].中华外科杂志, 1999, 37(5): 301-303.
[20] Ludwig SC, Kramer DL, Balderston RA, et al. Placement of pedicle screws in the human cadaveric cervical spine: comparative accuracy of three techniques
[J]. Spine, 2000, 25(13):1655-1667.
[21] Kosmopoulos V, Schizas C. Pedicle screw placement accuracy: ameta-analysis
[J].Spine, 2007, 32(3):111-120.
/
〈 |
|
〉 |