关键词: 颈椎, 屈曲牵张型损伤, 前路钢板固定, 轴向螺钉, 解剖

Abstract:

Objective　To study the anatomical flexibility of anterior cervical plating plus axial screw fixation for treating cervical flexion-distraction.　Methods　Fifty cases of digital lateral X-ray films from adult healthy volunteers aged 24~48 years, with mean 28 years, were measured directly in the JW-PACS picture system. Measuring parameters included vertebral body height, intervertebral disc height and disc depth. The line started from anteroinferior point of the inferior vertebrae to posterosuperior point of the superior vertebrae was drawn to mimic the axial screw fixation in the lateral film. The maximal screw length, screw cephalic inclination angle and the distance between screw and anterior vertebral margin at disc level was recorded. Simulated anterior cervical plating and axial screw fixation was carried out in one preserved human specimen under the guidance of C-arm X-ray fluoroscope.　Results　The maximal length of anterior cervical axial screw was (41.18±3.92 )mm, and the axial screw inclination angle (25.21±3.58)°. The suitable depth of interbody graft was more than （11.69±1.63）mm, but less than （17.09±1.50）mm of disc depth. Simulated procedure in the preserved specimen demonstrated that axial screw fixation could be successfully completed at C2/3, C3/4, C4/5, and C5/6 levels, but difficult be performed at C6/7 due to obstacle of sternum.　Conclusions　The flexibility of axial screw fixation plus anterior cervical plating is confirmed from this study for managing of cervical flexion-distraction injuries.

Key words: Cervical spine, Flexion-distraction injury, Anterior cervical plating, Anterior axial screw, Anatomy