颈椎单开门微型钢板固定在颈椎侧块置钉方法改进的解剖研究

doi:10.13418/j.issn.1001-165x.2021.05.001

中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (5): 503-506.doi: 10.13418/j.issn.1001-165x.2021.05.001

• 应用解剖 • 下一篇

颈椎单开门微型钢板固定在颈椎侧块置钉方法改进的解剖研究

吴洁石¹，　薛骏¹，　袁凤来¹，　赵鹏²，　赵全明¹，　徐瑞生¹

1. 江南大学附属医院骨科，江苏无锡 214122；　2. 江南大学医学院解剖学教研室, 江苏无锡 214122

收稿日期:2020-01-09 出版日期:2021-09-25 发布日期:2021-09-28
通讯作者: 徐瑞生，医学博士，主任医师，硕士生导师，Tel： 13093051280，E-mail：xu86226@foxmail.com
作者简介:吴洁石（1977-），医学硕士，副主任医师，研究方向：脊柱外科脊髓神经损伤修复，E-mail：wu_jieshi@hotmail.com
基金资助:
国家自然科学基金面上项目（81770876）；无锡市“太湖人才计划”医疗卫生高端人才科研项目（2020-50）

An anatomical study of the improved screw placement in the mini-plate fixation of lateral mass for cervical open-door laminoplasty operation

Wu Jieshi¹, Xue Jun¹, Yuan Fenglai1, Zhao Peng², Zhao Quanming¹, Xu Ruisheng¹

1.Department of Orthopedics, Affiliated Hospital of Jiangnan University, Wuxi 214122, China; 2. Department of Anatomy, Medical College of Jiangnan University, Jiangsu 214122, China

Received:2020-01-09 Online:2021-09-25 Published:2021-09-28

摘要/Abstract

摘要： 目的　为颈椎单开门手术中微型钢板侧块固定螺钉更为安全的钉道和置钉方向提供解剖学基础。方法　选取50套C3~7椎骨标本，确定微型钢板固定侧块时上、下两枚螺钉在颈椎侧块上的进钉点A和B，测量垂直颈椎侧块表面进钉的钉道长度A1和B1，以及头倾15°进钉的钉道长度A2和B2。结果　A1的平均值C3（9.4±1.2）mm、C4 (11.7±2.8) mm、C5（12.9±2.5）mm、C6（12.0±2.3）mm、C7（10.4±1.8）mm；A2的平均值C3（11.9±1.6）mm、C4（15.3±1.7）mm、C5 (15.7±1.7) mm、C6 (14.2±1.3) mm、C7 (13.5±1.0) mm均大于11 mm； B1的平均值C3（4.7±0.6） mm、C4（5.0±1.1）mm、C5（5.8±0.9） mm、C6（5.5±0.6）mm、C7（5.3±0.4）mm，钉道长度<5 mm的占比分别为57%、46%、28%、27%和35%。B2的平均值C3 (6.8±0.8) mm、C4 (7.0±2.1) mm、C5 (7.8±1.4) mm、C6 (8.5±0.8) mm、C7 (7.6±0.6) mm均大于5 mm。结论　微型钢板颈椎侧块固定时，为避免螺钉尖端穿出颈椎侧块前方，宜按头倾15°建立钉道，头端一枚可选择长度9 mm的螺钉、尾端一枚宜选择长度5 mm的螺钉，头倾15°建立钉道可以增加钉道的长度并避免螺钉尖端突破侧块前方而破坏小关节的关节面。

关键词: 颈椎病, 　颈椎, 　椎管扩大术, 　脊髓减压术, 　骨钉, 　颈痛

Abstract: Objective　To provide the anatomical basis for a safer screw direction and screw path for cervical microplate side mass fixation screws in cervical open-door laminoplasty operation.　Methods　The points of A and B on the surface of lateral mass for setting cephalic and caudal screws to fix the plate were determined in 50 specimens of C3~C7 vertebra, the length of vertical screw path A1 and B1 and head tilt of 15o A2 and B2 were measured.　Results　The mean value of A1 length in cervical vertebra was C3 (9.4±1.2) mm, C4 (11.7±2.8) mm, C5 (12.9±2.5) mm, C6 (12.0±2.3) mm, C7 (10.4±1.8) mm. The mean value of A2 length was C3 (11.9±1.6) mm, C4 (15.3±1.7) mm, C5 (15.7±1.7) mm, C6 (14.2±1.3) mm and C7 (13.5±1.0) mm, which were all greater than 11 mm. The mean value of B1 length was C3 (4.7±0.6) mm, C4 (5.0±1.1) mm, C5 (5.8±0.9) mm, C6 (5.5±0.6) mm, and C7 (5.3±0.4) mm. The percentage of B1 length less than 5 mm in the C3, C4, C5, C6 and C7 vertebrae was 57%, 46%, 28%, 27% and 35%, respectively. The average length of B2 nail track in all cervical vertebrae specimens C3 was (6.8±0.8) mm, C4 (7.0±2.1) mm, C5 (7.8±1.4) mm, C6 (8.5±0.8) mm, and C7 (7.6±0.6) mm, which was greater than 5 mm.　Conclusions　When the cervical mini-plate is fixed to the lateral mass of cervical spine, in order to avoid screw's over length, it is necessary to set the screw path at the head tilt of 15o. The length of the cephalic screw can be 9 mm, and the caudal one should be 5 mm, which can efficiently avoid screw protruding out facet and hurting the articular cartilage of the cervical spine small joint.

Key words: 颈椎病, 　颈椎, 　椎管扩大术, 　脊髓减压术, 　骨钉, 　颈痛

中图分类号:

R323.1

吴洁石, 薛骏, 袁凤来, 赵鹏, 赵全明, 徐瑞生 . 颈椎单开门微型钢板固定在颈椎侧块置钉方法改进的解剖研究[J]. 中国临床解剖学杂志, 2021, 39(5): 503-506.

Wu Jieshi, Xue Jun, Yuan Fenglai, Zhao Peng, Zhao Quanming, Xu Ruisheng. An anatomical study of the improved screw placement in the mini-plate fixation of lateral mass for cervical open-door laminoplasty operation[J]. Chinese Journal of Clinical Anatomy, 2021, 39(5): 503-506.

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颈椎单开门微型钢板固定在颈椎侧块置钉方法改进的解剖研究

An anatomical study of the improved screw placement in the mini-plate fixation of lateral mass for cervical open-door laminoplasty operation

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