寰枢椎后方结构解剖学研究及临床意义

目的 测量寰枢椎后方结构相关数据，为设计寰枢椎后路内固定系统提供解剖学依据。 方法 测量30例寰椎和枢椎骨标本、50例男性和50例女性CT寰枢椎后方结构相关数据，分别比较骨标本、CT图像测量指标的侧别及性别统计学差异，比较骨标本数据和CT数据统计学差异。 结果 骨标本测得后中线处高（10.75±1.38）mm、厚（8.55±1.77）mm，内、外侧后中线到两侧椎动脉沟内侧缘距离分别为（13.45±0.73）mm、（20.28±2.20）mm，内、外侧缘后弓夹角分别为（141.00±3.43）°、（134.67±2.87）°。CT测量后中线处高（10.45±1.61）mm、厚（8.12±1.57）mm，内、外侧后中线到两侧椎动脉沟内侧缘距离分别为（13.60±1.26）mm、（20.48±2.05）mm，内、外侧缘后弓夹角分别为（141.23±9.64）°、（135.47±9.02）°，后弓外侧缘半径（26.77±2.14）mm，枢椎板斜率（58.34±7.60）°，寰椎后弓下缘至枢椎棘突上缘高（19.07±2.73）mm，寰枢椎后间隙高（6.83±2.01）mm。CT数据大部分性别差异有统计学意义（P<0.05）。骨标本和CT数据左右侧差异均无统计学意义（P>0.05）。骨标本与CT数据差异无统计学意义（P>0.05）。 结论 寰枢椎后方骨性结构解剖特征较为固定；CT能较好地反映该特征；本研究可为寰枢椎后路内固定系统设计提供解剖学依据。

Anatomical study and clinical significance of posterior atlantoaxial structure

Objective To measure the anatomical parameters of posterior atlantoaxial structure, so as to provide anatomic basis for the design of posterior atlantoaxial internal fixation system. Methods The anatomical parameters of 30 atlantoaxial vertebra specimens, CT posterior structures of atlantoaxial vertebra of 50 males and 50 females were measured. The CT data of different genders, bone and CT measurements on the left and right side, and bone and CT measurements were compared for statistical significance. Results The height and thickness of the posterior midline of the bone specimens were (10.75±1.38) mm and (8.55±1.77) mm, and the distances from the medial edge of the vertebral artery sulci on both sides to the posterior midline of the bone specimens were (13.45±0.73) mm and (20.28±2.20) mm, respectively. The posterior arch angles of the inner and outer edges were (141.00±3.43) ° and (134.67±2.87) °, respectively. The height and thickness of the posterior midline measured by CT were (10.45±1.61) mm and (8.12±1.57) mm, and the distances between the inner and outer posterior midline and the medial edge of the vertebral artery sulci by CT measurement were (13.60±1.26) mm and (20.48±2.05) mm, respectively. The angle of posterior arch of the inner and outer edges by CT measurement were (141.23±9.64) ° and (135.47±9.02) °, respectively, the radius of the outer edge of posterior arch was (26.77±2.14) mm, the slope rate of the vertebral lamina of the axial vertebra was (58.34±7.60) °. The height from the lower edge of the posterior arch of the atlas to the upper edge of the spinous process of the axial vertebra was (19.07±2.73) mm. The height of posterior atlantoaxial space was (6.83±2.01) mm. There were statistical differences in most of gender in CT data (P<0.05). There was no significant difference in bone specimens and CT data on the left and right sides (P>0.05). There was no significant difference between bone specimens and CT data (P>0.05). Conclusions The anatomical characteristics of posterior atlantoaxial bone structure is relatively fixed. CT can better reflect the characteristics. This study can provide anatomical basis for the design of the posterior atlantoaxial internal fixation system.