枢椎各结构的解剖学部位研究

目的：明确枢椎各结构的解剖部位。方法：对57例干燥成人标本进行观察与测量，对8例新鲜枢椎标本进行CT薄层扫描，寻找残存的C1-2椎体间连接痕迹。以此为依据，明确枢椎各结构的具体部位。对20例志愿者的枢椎CT三维重建以及MRI图像进行分析，验证前述结论。结果：枢椎前结构的前下方为一三角形的突起部分，皮质较厚，同典型颈椎的椎体相似；两侧的三角形突起与上关节突之间为皮质凹陷区域；CT扫描见枢椎上终板残留位于三角形突起的上厅1．2～1．8mm处，呈圆饼形跨越约1．8～2．4mm同齿突的下终板残留结合在一起。位于椎弓侧方的上下关节突间部分以横突孔后结节为界可分为前后两部分，前者内倾角、上倾角大，后者小。前者外壁菲薄，多数有滋养血管孔存在，而后者内外侧皮质厚度较一致。结论：枢椎的椎体为位于前结构下方的三角形突起部分，椎弓根位于上关节突与椎体之间，椎弓侧方为上下关节突之间的连接部分，被横突孔后结节分为横突孔内界及峡部两个部分，后者为典型Hangman骨折的部位。

The structuree and position of vertebra dentate:an anatomic study

Objective: To explore the accurate location on different structures of vertebra dentate. Methods: Fifty-seven dry vertebra dentate were used to observe the external anatomic characteristics from anterior, posterior, lateral superior and inferior directions. Eight fresh vertebra dentate were made CT scan to find out the trace of intervertebral connection between atlas and axis. Three-dimensional reconstruction computer image were done to observe external structures of vertebra dentate and MRI images were done to find out the location of trace of C1-2 intervertebral disc. Results: There was a triangle-like protrusion area at the anterior-inferior portion of vertebra dentate. The concave area between this area and superior articular process can be found. The lateral arch consisted of pars interarticularis, which can be divided into two portions by posterior nodule of transverse foramen , the anterior portion was more medial and vertical and the posterior portion was more lateral and horizontal. The lateral cortex of the anterior portion was thin with nourishing vessel penetrating into it while the lateral cortex of the posterior portion was as thick as its medial counterpart. CT scan showed that the trace of superior end plate of axis located 1.2-1.8 mm above the apex of triangle bone and extended about 1.8-2.4 mm upward to connect with the trace of the inferior end plate of odontoid process. Three-dimensional reconstruction image of vertebra dentate showed clearly the triangle-like protrusion area and bilateral concave areas of vertebra dentate. MRI images demonstrated that all the trace of the superior end plates connected the trace of the inferior endplate of odontoid process with the trace of C1-2 intervertebral disc. Conclusions: The actual vertebral body of vertebra dentate is the triangle-like protrusion area at the anteriorinferior portion of the anterior structure of vertebra dentate. The pedicle locate at the concave area between the superior articular process and vertebral body. The pars interarticularis occupy the location of lateral arch, which can be divided into two parts by posterior nodule of transverse foramen. The posterior portion which frail for fracture should be the real isthmus of pars interarticulris, while the anterior portion which is the extension between posterior nodule and superior process is relatively stronger to resist violence.