寰椎测量及其经后弓侧块螺钉固定通道的研究

目的：提供国人寰椎的数据，探讨经寰椎后弓侧块（类似椎弓根）螺钉固定的可行性。方法：用游标卡尺对50例干燥寰椎标本进行测量。在实验研究的基础上，对5例寰枢椎不稳患者采用经寰椎后弓侧块螺钉和枢椎椎弓根螺钉加钢板内固定，术中用卡尺和量角器测量寰椎后弓进钉点及进钉方向，术后在X光片和CT片上测量经寰椎后弓侧块螺钉通道。结果：测量得出寰椎后弓、侧块、椎动脉沟、后弓进钉点、后弓侧块螺钉通道的轴线长度及进钉方向等参数。临床5例10枚经寰椎后弓侧块螺钉均准确置入寰椎内，无穿破骨皮质或损伤神经血管病例。结论：寰椎具备行经后弓侧块螺钉内固定的条件。

Anatomic study of atlas and the pass using screw fixation via posterior arch and lateral mass

Objective:To provide anatomic data of atlas of Chinese people and discuss the feasibility of screw fixation via posterior arch and lateral mass of atlas.Method:50 dry samples of atlas were measured with vernier calipers and protractors;in five cases of operations using atlas screws via posterior arch and lateral mass and axis pedicle screws associated with plates fixation,the projection and direction of screws were measured with vernier calipers and protractors,and the every screw pass was measured in the X ray and CT plates obtained post operatively.Result:the parameters of posterior arch,lateral mass,vertebral artery groove?axial length of screw pass via posterior arch and lateral mass,projection and direction of screw were measured.10 screws via posterior arch and lateral mass were inserted correctly,without cortex breakage and nerve or blood vessel injury in clinical practice.Conclusion:It has the feasibility that screw fixation can be used in atlas via posterior arch and lateral mass.