后路经寰枕关节螺钉固定钉道的测定

目的:明确后路寰枕关节经关节螺钉固定的技术参数;探讨枕颈部经关节螺钉内固定技术的临床意义。方法:30例含完整寰枕关节干燥骨性标本,直视下行后路寰枕关节经关节克氏针植入后行X线摄片,在X线片上测量寰枕关节经关节螺钉固定的钉道角度和长度。结果:寰枕关节经关节螺钉固定的钉道理想角度为:螺钉方向在矢状面的上倾角为(53.3±3.4)°,在冠状面的内倾角为(20.0±2.6)°。钉道长度为(29.28±2.46)mm。结论:寰枕关节后路经关节螺钉植入存在一定的方向性和钉道长度,结合后路C1-C2经关节螺钉内固定后可视为能满足当前临床需要的一种相对理想的枕颈融合内固定术式。

Determination of the parameters in posterior atlanto-occipital transarticular screw trajectory

Objective:To clarify the technical parameters in posterior atlanto-occipital transarticular screw fixation and discuss the clinical significance of occipitocervical junction fixation with transarticular screws.Methods:Posterior atlanto-occipital transarticular Kirschner wire implantation was performed under visual control on 30 dried bony specimens that contained complete atlanto-occipital articulation,and cephalocaudal and lateral X-rays were taken,on which the angle and the length of the screw trajectory were measured.Results:The atlanto-occipital transarticular screw trajectory was cephalad tilting in sagittal plane and medially tilting in coronal plane;the ideal angle of the trajectory was(53.3±3.4)°upper tilting in sagittal plane and(20.0±2.6)°midline tilting in coronary plane.Length of the trajectory was(29.28±2.46)mm.Conclusion:Direction and length of trajectory are the key of posterior atlano-occipital transarticular fixation,if combined with C1-C2 transarticular fixation,it will be an ideal fixation method for occipitocervical fusion.