成人寰椎后弓解剖学研究及内固定钉板系统设计

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Abstract Objective To identify the anatomical feasibility of screwplate system adopted in posterior arch of atlas，provide a reference for clinical applications.Methods A total of 60 3D CT and 30 dry atlas specimens were used to measure anatomical data.The parameters included anterior to posterior thickness and superior to inferior height of the posterior ring of C₁ at the midline as well as at 5mm，10mm，15mm lateral to the midline，angle of posterior arch，internal semi-distance of the outside screw(from midline to outer edge of screw in inner side)，distance from the planned cross nail entry point to the edge of outer screw which called supposed biggest length of cross screw(where screws completely located in the medullary cavity without touching the outer screw).The data gained from CTs and specimens were then compared.The anatomy of the atlas was analyzed and the design of internal fixation screw-plate system was performed.Results The height of the center of posterior nodule was (9.48±0.95)mm，and the respective thickness was (7.80±1.60)mm，the angle of posterior arch was (130.70±12.31) °，the biggest length of cross screw was (13.67±0.53)mm and the supposed internal semi-distance of the outside screw was (10.51±0.95) mm tested in CTs. The respective parameters from specimens were (9.97±2.18)mm，(7.44±1.32)mm，(135.07±9.59)°，(14.17±0.54)mm and (11.03±1.07)mm.No statistical difference was found between data of the left side and the right side，whereas the outcomes including the biggest length of cross screw and the supposed internal semi-distance of the outside screw from CTs were smaller than those from specimens with statistical difference.Conclusion Data measured from CT provides a reference in clinical practice but can not present anatomical structure precisely.It is feasible and safe for posterior arch screw-plate fixation system in anatomy which may be an new alternative of atlantoaxial fixation.

Key words： atlas internal fixation screw-plate anatomy

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