经滋养孔枢椎椎弓根螺钉进钉的解剖学研究
收稿日期: 2014-02-23
网络出版日期: 2014-12-04
基金资助
江西省科技厅科技计划项目 (No. 20123BBG70037)
The anatomical study of the entry point of axis pedicle screw by posterior nutrient foramens
Received date: 2014-02-23
Online published: 2014-12-04
目的 探讨以椎板后方滋养孔作为枢椎椎弓根螺钉进钉点的相关解剖学参数。 方法 30例成人枢椎干骨标本，以椎板后方双侧滋养孔为枢椎椎弓根螺钉进钉点。用大头针进行标记后，将标本进行CT扫描。随后将扫描图像导入测量软件，分别测量进钉点与椎板上缘、下缘及椎弓根内壁的距离；测量进钉长度及角度。 结果 97%的枢椎左侧椎板和93%的右侧椎板存在滋养孔。其与椎板上缘的距离为(3.36±0.57) mm，与椎板下缘的距离为（8.41±1.08）mm，与椎弓根内壁的距离为(6.91±1.20)mm。以双侧滋养孔为进钉点，椎弓根螺钉的平均进钉长度为(24.71±1.35)mm，进钉的内倾角平均为(20.17±3.65) °，上倾角平均为(31.02±5.71)°。 结论 通过解剖学测量，椎板后方滋养孔可作为枢椎椎弓根螺钉的固定进钉点的一种选择。
刘家明 , 江建 , 刘志礼 , 龙新华 , 陈文昭 , 周扬 , 高松 , 何来昌 , 黄山虎 . 经滋养孔枢椎椎弓根螺钉进钉的解剖学研究[J]. 中国临床解剖学杂志, 2014 , 32(6) : 637 -639 . DOI: 10.13418/j.issn.1001-165x.201
Objective To determine the related linear and angular parameters about the new entry point (nutrient foramens) of C2 pedicle screw on computed tomography images. Methods 30 dry C2 vertebrae were obtained for anatomic measurement in the study. The posterior bilateral nutrient foramens of C2 lamina were selected as the entry points for pedicle screw placement. The foramens were marked with needles and then the vertebrae underwent computed tomography (CT) scan. The images of C2 pedicles were harvested and four linear and two angular parameters about the entry point were determined. Results The nutrient foramens exist in 97% of the left lamina and 93% of the right lamina of C2 vertebra. The overall mean distance from the entry point (nutrient foramen) to the superior border of lamina, to the inferior border of lamina, to the medial border of the pedicle were （3.36±0.57）mm, （8.41±1.08）mm and （6.91±1.20）mm, respectively. The length of the pedicle screw trajectory was （24.71±1.35）mm. The average transverse angle and the superior angle were（20.17±3.65）° and（31.02±5.71）°, respectively. Conclusion According to the measurement, the posterior bilateral nutrient foramens of the lamina can be used as a fixed landmark to locate C2 pedicle screw placement.
Key words： Axis; Nutrient foramen; Pedicle; Anatomical measurement
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