Chinese Journal of Clinical Anatomy

Anatomy and clinical significance on blood supply of the subaxial cervical vertebrae

LIN Yong-sui, WANG Wan-ming, ZHENG He-ping, ZHANG Fa-hui, WANG Chun

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 247-250.

Abstract ( 1913 )

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Objective To provide anatomic basis for reducing hemorrhage within operating field, improving operation exposure and reducing complication in cervical anterior decompression procedure through illuminating the feature of blood supply in subaxial cervical vertebrae.　Methods　The origin, course, distribution and anastomosis of anteroposterior blood supply were observed at C3-7 of 15 adult cadaveric specimens perfused with red latex.　Results　Anterior cervical vertebral artery originated from spinal branches of ascending cervical artery, inferior thyroid artery and pinal branches of deep cervical artery. Its branches distributed at anterior cervical vertebrae, among which the branches at superior 1/3 segment of vertebrae were grossusest, and anastomosed with the branches in opposite side. The branches of anterior vertebral artery in C4-7 anastomosed with each other, and formed a longitudinal arterial chain at the medial margin of longus colli muscle. Posterior cervical vertebral artery originated from vertebral artery or ascending cervical and deep cervical arteries, and its branches sent out ascending and descending branches fairly at lateral border of dura mater, which formed a segmented vaulted arterial chain at posterior cervical vertebrae, which sent out 1-2 relatively grossus branches at central region of vertebrae, and anastomosed with the branches in opposite side. Conclusions　Interrupting anterior vertebral arteries of underwent vertebrae and anastomosis of longitudinal arteries with adjoining anterior vertebral arteries, and paying attention to deal with posterior vertebral arteries and its branches at central region of vertebrae and lateral border of dura mater when decompressing at posterior part of cervical vertebrae could reduce hemorrhage within operating field and improve operation exposure in cervical anterior decompression procedure.

Anatomic features of the the Dorello's canal and its clinical significance

ZHANG Yi, YU Hao, JIN Guo-Hua, CHEN Xia

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 251-255.

Abstract ( 2391 )

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Applied anatomy of the sartorius perforator flap

SUN Feng, HUANG Dong, TUN Wei-Chi, MAO Yong, MA Xiao-Fen, ZHOU Chao-Long

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 268-270.

Abstract ( 1848 )

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Objective　To ascertain blood supply distribution of the sartorius perforators，including myocutaneous branches and direct cutaneous perforator, and provide anatomic basis for clinical application of sartorius perforator flap.　Methods　Twelve fresh unfixed corpses with red latex injection were dissected layer by layer. The distribution characteristics of dominant arteries of sartorius and the number of perforators were observed and analyzed. Results There were generally 7~12 perforating branches in sartorius muscle, from femoral artery, lateral femoral circumflex artery or descending genicular artery. The middle and inferior parts of sartorius received 3-4 myocutaneous perforators and 2-3 intermuscular space perforators originated from femoral artery, with the average external diameter of (1.7±0.6)mm, and the pedicle length of (2.8±1.2)cm. The perforators from the same origin were common.　Conclusions　Considering that perforating branches appeared in the lower part of sartorius muscle are abundant and constant, which is more feasible to design flap for tissue defect repair.

The surgical safe zone of the anterior plate and screw fixation on sacroiliac joint: applied anatomy

LIU Jia, SUN Shan-Quan, NI Wei-Dong, JIANG Dian-Meng, GAO Shi-Chang

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 271-274.

Abstract ( 1642 )

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Objective To explore the surgical safe zone of the anterior plate and screw fixation for treating sacroiliac joint fracture and dislocation. Methods 15 normal pelvic specimens were used. The horizontal distances from L4, L5 anterior roots to the sacroiliac joint, the vertical distances from L4, L5 roots to sacral wing, the distances from the intervertebral foreman of L4, L5 to the rim of true pelvis, and the diameter of the L4, L5 roots were measured respectively. On two dimensional pelvic coronal reconstruction images, the angle between sacroiliac joint and sagittal plane, the width of the sacrum were tested. Results The horizontal distance from the lateral side of the L4, L5 roots to the sacroiliac joint gradually diminished from the top to the bottom, with the widest of (2.1±0.2）and （2.7±0.2）cm respectively, and the narrowest of （1.2±0.2）cm and（1.5±0.2）cm respectively. The vertical distances between the L4 root and the sacrum also diminished gradually from the intervertebral foramen to the rim of the pelvis. The length of the L4 and L5 roots were（7.4±0.8）cm and 3.9±0.5）cm, and the diameters (2.7±0.8）mm and （7.3±1.4）mm respectively. On CT reconstruction images, the angle between sacroiliac joint and sagittal plane was about 30°, and the distance from the sacroiliac joint to the lateral side of the spinal canal changed from 3.3cm to 2.3cm, the horizontal distance from the sacroiliac joint to the lateral side of the intervertebral foramen was about 2cm. Conclusions The surgical safe zone of the anterior plate and screw fixation for treating sacroiliac joint fracture and/or dislocation can be defined as the follows: the upper and lower plates places on the upper third of the sacroiliac joint, with the limited exposure range of 2.5cm, or the middle third of the sacroiliac joint, with the limited exposure range of 1.5cm. The screw should be inserted with introversional angle of 300.

Anatomy basis of unguided sacroiliac joint puncture

JU Yu-Cong, LI Xi-Kai, YANG Xian-Wen, CHEN Run-Qi, XU Cheng-Fu

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 275-278.

Abstract ( 1727 )

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Objective　To provide anatomic basis for the feasibility and safety of unguided sacroiliac joint puncture. Methods 3 sacroiliac joint section specimens, 4 dried pelvic specimens (2 male, 2 female) , 4 antiseptic cadaveric pelvic specimens (3 male.1 female) and 62 ankylosing spondylitis patients' sacroiliac joint CT imaging data were collected and measured. The injection target was designated at the sagittal synovium part below the posterior superior iliac spine. Results The average length of sagittal synovium part was about（18.40±3.40）mm in male and （17.32±3.60）mm in female(P>0.05); The average distance between the posterior midline and sagittal synovium part was （41.00±3.30）mm in male and （42.74±4.00）mm in female(P<0.05), with the significant difference; The average distance between the midpoint and posterior superior iliac spine was（27.66±3.10)mm in male and （28.76±3.50）mm in female respectively(P>0.05). Conclusions According to the sex and thickness of fat, conducting injection in the area of （41.00±3.50）mm away from the posterior midline, （28.00±3.20）mm from the posterior superior iliac spine makes puncture entering the sacroiliac joint more accurately, easily, and successfully.

Effects of the position of the components on hip motion in the virtual total hip replacement

SHI Hai-Bei, CHEN Shi-Rong, LIU Miao, XU Xi-Dong, PENG Mo-Jiang

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 279-284.

Abstract ( 1519 )

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　Objective　To explore the effects of the position of components on hip joint motion in the virtual total hip replacement.　Methods　Based on digital CT images, a three-dimensional computer model of the hip after total hip replacement were created by the use of computer three-dimensional reconstruction and virtual surgery technology. The model was designed to simulate joint motion and get maximum range of motion before joint impingement at different positions.　Results　(1) Excerpt for the range of external rotation, the increase of acetabular abduction induced the increase of the range of flexion, extension and internal rotation at 90° flexion. The increase of the acetabular and femoral anteversion induced the increase of the range of flexion and internal rotation at 90° flexion, but the decrease of the range of extension and external rotation. (2) To meet the needs of daily activities, the greater acetabular abduction required appropriately decreased acetabular anteversion. The relative position of acetabular abduction and femoral anteversion depended on the acetabular anteversion.　Conclusions　It's important to confirm the relative position of the components during the total hip replacement. Furthermore, this result is valuable for guiding the prosthesis implantation in reversion surgery and the range of daily activities in patients with postoperative dislocation.

Multi-branch variation of low coeliac trunk: one case report

SHU Jia-Yuan, MA Jian-Jun, DUAN Jia, WANG Yi-He, ZHOU Xiao-Dan, CAO Hua-Hui, WANG Xiao-Fang, HE Wei

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 284.

Abstract ( 1352 )

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Three dimensional anatomical measurement and diagnostic criteria of jaw protrusion deformity

CHU Jing-Jing, JI Xiang-Dong, QIN Jian-Ceng, HUANG Shi-Qing, XIE Qiang-Wei, ZHANG Zong-Fu, ZHONG Shi-Tian

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 285-287.

Abstract ( 1242 )

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Objective　To explore and establish a three-dimensional anatomical measurement method and diagnostic criteria for the jaw protrusion deformity.　Methods　We established a computer-aided three-dimensional measurement of jaw protrusion deformity after comparatively analyzing the data of cephalometric piece for 14 volunteers.　Results　①On the median sagittal plane, the connection between nasion and anterior alveolar seat point (NA), between nasion and inferior alveolar seat point(NB), and between eye and ear plane(FH) were firstly established. Then the angle α (between NA and FH), and the angle β (between NB and FH) were established to reflect the relationship between the maxilla and the mandible for the location of the skull. We initially established the diagnosis criteria for the angle α (88°~93°) and the angle β (87°~90°). ②Statistical data showed that, there was no significant difference between two-dimensional and 3D measurement of normal human jaws, but there was significant difference between those two methods in abnormal human jaws.　Conclusions　The computer-assisted construction of jaw protrusion deformity and three-dimensional anatomical measurement is feasible, which reflects the relations of lines and surfaces of three-dimensional spatial relations, improves the accuracy of the diagnosis, and provides an objective basis for diagnosis and treatment of jaw deformity.

Morphologic features and clinic significance of the terminal site of the arantius ligament

ZHOU Zheng, YANG Ding-Hua, DING Zi-Hai

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 288-290.

Abstract ( 2169 )

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Objective To provide anatomic basis for dividing arantius ligament to expose the back of left hepatic vein. Methods Morphologic features of arantius ligament on 33 cadavers, especially its proximal attachment site, were observed and analyzed. Results The proximal attachment sites of arantius ligament were variant. The dorsal side of left hepatic vein could be dissected succefully. Conclusions Cuting the arantius ligament is reliable for exposing of left hepatic vein.

Joint interval of the occipitocervical complex: image comparision and clinical significance

LIN Wei, WANG Jian, YUAN Wu, SHAO Hang, LI Yun-Sheng

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 291-294.

Abstract ( 1709 )

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Objective　To examine and compare image data of normal joint interval of occipitocervical complex (OCC) on colloidin microsection, CT and MRI, and judge the accuracy of OCC data under different methods.　Methods　24 specimens from normal upper cervical vertebra were use in this study. The specimens were scanned under CT and MRI firstly, followed by the collection of OCC images. After that, the specimens were embedded into celloidin and cut into successive slices with 1mm thickness (12 horizontal, 6 sagittal, 6 coronal sections). Observation and analysis were performed on the relative joint intervals originated from different sources of images.　Results　The distances of joint intervals included atlantoodnoid interval (ADI), lateral atlantoodnoid interval (LADI), alantooccipital interval (AOI), atlantoaxial interval (AAI), basion-axial interval (BAI) and basion-dens interval (BDI). Statistical analysis showed that there were no significant differences among different image data.　Conclusions　This result provides morphologic basis for clinic application. CT and MRI images, especially MRI images, are reliable for evaluating the details of OCC.

The tympanic and mastoid segments of facial nerve: the location on the oblique sagittal section and HRCT and clinical significance

ZHONG Bin, LI Qing-Feng, ZHOU Man, DUAN Ju-Ru, TUN Yang-Ning, HUANG Chang-Cheng

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 295-298.

Abstract ( 1537 )

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Objective　To investigate the optimal scan baseline of the tympanic and mastoid segments of facial nerve on the oblique sagittal sections, and provide anatomic basis for image diagnosis and microsurgical application.　Methods　The high resolution CT was used to scan 16 cadaveric specimens (32 ears) on the oblique sagittal plane，after that, celloidin embedding was used to cut and obtain oblique sagittal sections of temporal bone with the thickness of 1mm. CT and specimen section images were analyzed and compared. Results　All of 16 specimens (32 ears) showed the course of tympanic and mastoid segments of facial nerve on CT oblique sagittal plane, with the length of （23.58±1.44）mm. The distance from the tympanic segment to external semicircular canal was（0.75±0.12）mm，from tympanic segment of the facial nerve to the tympanic cavity （0.34±0.08）mm，and the angle between tympanic segment and mastoid segment was（108.880±2.490）. Conclusions　The oblique sagittal HRCT images combined with the corresponding specimen sections are reliable for displaying the tympanic and mastoid segments of facial nerve and its surrounding structures. The best vision can be get on the oblique sagital plane, which formed the angle of（21.400±4.350）with the median sagittal plane .

Applied anatomy of myocardial bridge-mural coronary artery by dual-source CT

YU Kang-Hui, CHENG Guan-Xun, LIU Guo-Shun, YAN Jing

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 303-306.

Abstract ( 1546 )

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Objective　To study the morphologic features of myocardial bridge-mural coronary (MB-MCA) by dual-source CT (DSCT), and improve the understanding of it on clinical diagnosis value. Methods　3709 patients were involved in this study. MB-MCAs were located accurately according to the guideline of the American Heart Association, and the length, depth, compression of MB-MCA and concomitant atheromatous changes were evaluated.　Results　638 cases had MB-MCA in overall 3709 patients by DSCT, getting the prevalence of 17.20%. 654 MB-MCA were detected including 426 in segment 7, 72 in segment 8 and 56 in segment 6, the rest distributing in segment 2, 3, 4, 9, 11, 12,13 and 16. Of 654 MB-MCA, the mean length was (20.52±9.84）mm and the mean thickness was（1.27±0.93）mm. The lumen of MCA showed no significant stenosis or mild to moderate stenosis, and a rare severe stenosis. 92 patients with MB-MCA had atherosclerotic plaque.　Conclusions　DSCT not only may directly demonstrate the dissection shape of MB-MCA, but might also dynamically evaluate the change of MB-MCA in the entire cardiac cycle, supplying the clinical significance research of MB-MCA for valuable information.

Acute myoinjury induce the intramuscular infiltration of CD8+ CTL cells

FENG Li-Jiang, CENG Hui-Jun, LIU Nie-Hui, CHEN Rong, HUANG Wei-Yi, LIAO Hua

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 307-310.

Abstract ( 1838 )

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Objective　To investigate the intramuscular infiltration of CD8+ cytotoxic T-cells （CTL cells） after crush myoinjury.　Methods　Tibialis antierior muscle(TA) crush was performed in C57BL/6 mice. HE staining was used to identify inflammatory reaction，degeneration and regeneration of crushed TA muscle. Immunofluorecence was used to detect pro- and anti- inflammatory cytokines, and the intramuscular infiltration of CTLs in injuried muscle.　Results　Crush induced significant myofiber necrosis, degeneration and regeneration. Conspicuous mononuclear cell infiltrates were detected at both d4 and d7 after crush injury. At d7 post-injury CTLs expressing perforin or IFN-γ were conspicuously detected in crushed muscle where CD8+ T-cells were found in close contact with regenerating myofibers.　Conclusions　After crush injury, CD8+ T cells infiltrate the injured muscle at regenerating period, and are transiently activated as CTL cells.

Caspase-3 expression in spinal tissue of retinoic acid induced spina bifida fetal rat

MA Yang-Huan, YUAN Zheng-Wei

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 311-314.

Abstract ( 1462 )

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Objective To explore caspase-3 expression in spinal tissue of retinoic acid induced spina bifida fetal rat.　Methods　Pregnant Wister rats with 10 days were used. Retinoic acid dissolved in olive oil (40mg /ml) were stomach fed for preparing the rat model of spina bifida malformations 135mg / kg). Control group only received olive oil. The animals were divided into 4 groups: pregnancy of 12 days, 15 days, 17 days and 20 days. Immunohistochemical method was used to detect and compare caspase-3 expression in different groups.　Results　The expression of caspase-3 increased at the day 15 after pregnancy, and maintained until day 20 in the spinal tissue of modeled fetal rat, which presented significant difference compared to that of control groups at the same pregnant time. At day 15, day 17 and day 20 of pregnancy, the number of caspase-3 positive cells was more in model animals than the control.　Conclusions　Retinoic acid induced spina bifida fetal rat demonstrates the increased caspase-3 expression in spinal tissue of fetal rats.

A case of variation renal artery with right testicular artery

LIU Juan

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 314.

Abstract ( 888 )

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The role of PGE2 and NF-κB pathway during the bone regeneration

QIU Xiao-Zhong, WANG Guo-Bao, HU Xiao-Fang, WANG Yong-Kuai, ZHANG Ma-Hui, WANG Le-Yu

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 315-319.

Abstract ( 1736 )

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Objective To study the relationship between the PGE2 production and NF-κB activation in bone regeneration, by combined analysis of the PGE2 production and NF-κB activation in the MC3T3-E1 cells and rat fracture model. Methods PGE2 and NF-κB inhibitor BAY 11-708246 were used to deal with MC3T3-E1 cells and rat fracture model. PGE2 production, NF-κB activation and the expression of BMP-7, Id2 and SOD2 were detected during the bone regeneration adopting ALP activity assay, western blot, EMSA analysis and ELISA assay. Results After being challenged with 10umol/l PGE2 for 10 min, 30 min and 2h respectively, both of the cell proliferation and differentiation of MC3T3- E1 cells were induced. However, 5umol/l BAY 11-7082 can inhibit the effects of PGE2. This implied that PGE2 induced the expression of ALP through the NF-κB pathway. Local treatment of BAY 11-7082, the production of PGE2 was decreased. On the other hand, Higher NF-κB activation, higher expression of BMP-7and SOD2, and the lower expression of Id2 were appeared in the site of bone fracture. After being injecting of BAY 11-7082, the expression of BMP-7 and Id2 were restored, while the expression of SOD2 was kept unchanged. Conclusions PGE2 can inhibit the expression of Id2 and the activation of NF-κB at the same time during the bone regeneration.

Amphetamine induced behavioral alteration and fiber injury in the striatum of mice

LIN E-Li, QI Bao-Gui, MA Li-Hua, BO San-Jiang, CAO Chang-Shu, ZHOU Li-Bing

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 320-323.

Abstract ( 1666 )

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Objective　To explore amphetamine-induced behavioral alteration, and fiber injury in the mouse striatum.　Methods　Mice were randomly divided into the normal, saline and amphetamine groups. The amphetamine group was subdivided into 1d，7d，14 d and 28 d groups. Mice were treated with amphetamine 2 mg·kg-1·d-1 via intraperitoneal injection in the amphetamine group. Autonomous behavior activities were tested during establishing amphetamine model. Nauta method was used to study the injury of fibers in the mouse striatum induced by amphetamine.　Results　Behaviour test showed that total moving distance, average speed, maximum speed, moving fast time/total time in the amphetamine groups at 7, 14 and 28 days were increased as compared with the normal group and saline group (P<0.05). There was no difference in moving slow time/total time between the amphetamine group and others groups (P>0.05). Nauta staining demonstrated black degenerated nerve fibers in mouse striatum of amphetamine groups at 14 and 28 days.　Conclusions　Amphetamine may increase many autonomous behavior activities and cause the degeneration of nerve fibers in the mouse striatum.

The study of a new artificial bone consisted with polylactic acid and nano-hydroxyapatite

HUANG Jiang-Hong, WANG Da-Beng, LIU Jian-Quan, MA Jing-Shu

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 324-328.

Abstract ( 1472 )

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Objective　To prepare a new artificial bone material by in situ polymerization of polylactic acid and nano-hydroxyapatite. Methods According to a specified ratio (the mass fraction of nano-hydroxyapatite respectively was 0, 10%, 20%, 30%, and 40%), polylactic acid and nano-hydroxyapatite were composed by in situ polymerization, followed by the testing of material parameters, including mechanical, ultrastructural, dispersional features in vitro. The degradation rate of composite material was detected. Results With the increase of n-HA content, the tensile strength of composite material decreased, but the elastic modulus increased. 20% of nano-hydroxyapatite content, made the best bending strength of composite material (156.8 MPa). SEM scan showed that, the fracture surface of pure PDLLA was relatively smooth; 10% of nano-hydroxyapatite content induced obvious dimples on the fracture surface. 20% nano-hydroxyapatite content induced uneven fracture surface, with a large number of dimples. However, 30% of nano-hydroxyapatite content made the fracture surface more flat. PH values of degradation liquid gradually reduced, as well the mechanical strength, following the extension of degradation. Conclusions Artificial bone material with 20% nano-hydroxyapatite content is ideal for its better mechanical properties and degradation properties.

The finite element analysis of Aerofoil shape memory alloy fixation instrument for surgically treating spondylolysis

SHU Li-Xin, WANG Jian, CAO Yan-Lin, FAN Wang-Ju, XU Guo-Ji, ZHANG Xi-Bing, XIE Wen-Meng

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 333-336.

Abstract ( 1574 )

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Objective　To establish the three-dimensional finite element model (FEM) with the bilateral pars defect and reconstruct by AEROFOIL fixation.　Methods　According to spiral CT scan images of 0.625 mm thickness，finite element model of lumbosacral vertebrae was established using Mimics10.01, Geomagic studio12.0, HyperMesh 10.0 and Abaqus10.1 software. Moreover, it's validity had been verified and then imported the AEROFOIL fixation. The reconstructed model was analyzed under 500N pressure loading on the upper surface of L1, and 7.5Nm torque loading for simulating axial compression and flexion, extension, lateral bending and rotation. The Von mises stress of fixation were recorded and analyzed.　Results　It showed that high stress concentrated at the bottom part of the swings, especially at the junction of the swings and the U-shape base. Extension and axial rotation motion resulted in breakage of the AEROFOIL fixation.　Conclusions　Improving Nitinol material quality and process standards and suitably prolonging the need for external bracing are necessary for reducing the higher risk of fracture on fixation devices.

Biomechanical effects on calcaneocuboid joint pressure after lateral column lengthening (Evans) procedure

ZHANG Feng, JIA Jiang, SHU Guang-Rong, DIAO Hong-Mou, YANG Yun-Feng

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 337-341.

Abstract ( 1356 )

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Objective To study the pressure change across the calcaneocuboid joint after lateral column lengthening (Evans) procedure and the best width of the lateral column distraction, for providing information and reference for Evans osteotomy. Methods Six fresh-frozen cadaveric specimens of foot were randomized into 7 experimental groups: intact, flatfoot deformity model, Evans osteotomy to extend the lateral columns of different widths (from 4mm to 12mm, in 2-mm increments). Vertical downward axial loads of 350N were applied to the specimens, the calcaneocuboid joint pressures were measured by the K-Scan joint analysis system and K-Scan6900# Sensor Model. Results Under loads of 350N, the calcaneocuboid joint peak pressure were: intact group: (9.21±1.60), flatfoot deformity model group: (24.90±2.45), LCL*4mm group: (21.68±2.21), LCL*6mm group: (15.95±2.59), LCL*8mm group: (11.04±1.15), LCL*10mm group: (15.20±2.35) and LCL*12mm group: (21.55±2.03) kg/cm2, respectively. The calcaneocuboid joint peak pressure was significantly higher in the flatfoot than intact group（P＜0.05); after the different Evans osteotomy, the pressure has been significantly reduced in LCL groups than the flatfoot (P <0.05)；there was no significant difference in the calcaneocuboid joint peak pressure between LCL*8mm group and intact group (P=0.143); the pressure in LCL*8mm group was relatively smaller than the other lateral column lengthening groups (P<0.05). Conclusions Lateral column lengthening by means of an Evans osteotomy within a certain extent will decreases the pressure across the calcaneocuboid joint on the flatfoot deformity. The pressure is minimal at the 8 mm width of the lateral column distraction, and we consider it near the normal state.

Three-dimensional Stability of Type Ⅲ Transoral Atlantoaxial Reduction Plate (TARP) System

DAN Lin, JIA Gong, DIAO Wei-Dong, LIU Ya-Pu, YANG Qiang-Lei, YIN Qiang-Shui

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 342-344.

Abstract ( 1377 )

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Objective To compare the in vitro biomechanics of Type Ⅲ Transoral Atlantoaxial Reduction Plate(TARP) system, with that of conventional posterior atlantoaxial pedicle screw-rods system, and provide biomechanical basis for clinical application. Methods 6 fresh-frozen human cadaveric cervical spines with occiput (C0~3) were used. Three different groups were examined: (1) control group (intact) (n= 6); (2) TARP group (n= 6); (3) pedicle screw-rods group (n= 6). All specimens were evaluated in flexion-extension, left-right bending, and left-right axial rotation with Motion Analysis in a cadaveric C1-2 fixation model with a nondestructive flexibility method using a nonconstrained skill. Results Stiffness in any direction was significantly higher in the TARP group and pedicle screw-rod group than in control group (intact). The difference in stiffness between the TARP group and pedicle screw-rod group was not statistically significant. Conclusions Experimentally, the TARP-Ⅲ system fixation and pedicle screw-rods fixation methods were significantly stiffer than the control group. The anterior TARP-Ⅲ system provided stiffness equal to posterior pedicle screw-rods fixation. Therefore, TARP-Ⅲ system seems reasonable that the reliable and rigid fixation would be the method of choice.

The finite element analysis on vertebral unit fixed system through ribs of T6~8

DIAO Yan, JIANG Jian-Meng, LI Xiao-He, HE Hong-Jun, ZUO Yuan, XIAO Yu-Long, YANG Hua-Jun-　

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 345-349.

Abstract ( 1633 )

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Objective　To develop a 3-D finite element(FE) model of bone graft with vertebral debridement and posterior vertebral unit fixed system through ribs of T6~8.　Methods　Spiral CT data of one male patient (172 cm, 71 kg, 39-year-old) with T7 vertebraltuberculosis were imported into computer to develop a 3-D FE model of bone graft with vertebral debridement and posterior vertebral unit fixed system by ribs of T6~8 by Mimics13.0 and Ansys11.0 finite element software. 500N pressure and 10Nm torque to the vertebral surface by 3 kinds of physiological load which simulating flexion, extension and lateral bending were exerted. The stress distribution of fixation devices under different loads was compared.　Results　At the positions of anteflexion and extension, the stress mainly concentrated to screw tail, and stress of the upper screw was greater than the lower screw, stress of the top was always greater than the bottom. At lateral bending position, stress of screw tail was less than that at flexion and extension. Stress was identical at the top and bottom of the vertical rods. For 3 different dynamics at the same points, stress of the extension was greater than anteflexion, stress of the anteflexion was greater than lateral bending at screw tail. Stress of anteflexion was greater than extension, and stress of the extension was greater than lateral bending at E and F points of vertical rods. Stress of vertical rod bottom at lateral bending was the least.　Conclusions　It prones to fatigue fracture at upper screw tail and the top of vertical rods by bone graft with vertebral debridement and posterior vertebral unit fixed system by ribs of T6~8 at the positions of anteflexion and extension.

Analysis on the anatomic factors in the etiology of spontaneous spinal epidural edema

LIU Cheng-Long, JIN An-Min, SHU Li-Xin, MIN Shao-Xiong, LV Hai

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 350-352.

Abstract ( 1432 )

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Objective　To explore the etiology, clinical presentation and treatment of spontaneous spinal epidural hematoma (SSEH).　Methods　10 cases presented with paraplegia were diagnosed as SSEH between 1995 to 2010 and received surgical operation. The characteristics of onset, clinical presentation, diagnosis, treatment and results of follow-up were analyzed.　Results　Followed-up for 6-18 months, 2 cases resulted in good recovery of nervous disfunction, while 8 cases showed no significant amelioration in spinal cord function. Conclusions　The etiology of SSEH remains indefinite and the prognosis is usually disappointed. Permanent spinal cord disfunction is seemly inevitable in most cases. Some anatomic reasons, such as epidural vascular malformation, may play an important role in the outbreak of SSEH

The treatment of trans-scaphoid perilunate fracture dislocation: open reduction and internal fixation with compression hollow screw

SHU Xiao-Di, WANG Li, LI Wen-Qiang, MAO Ren-Qun, YANG Chao-

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 353-355.

Abstract ( 1465 )

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Objective　To investigate the clinical effects of open reduction, internal fixation with pressure hollow screw and Kirschner wire on trans-scaphoid perilunate fracture-dislocation.　Methods　25 cases of trans-scaphoid perilunate fracture- dislocation were treated with open reduction, compression hollow screw fixation of the scaphoid, Kirschner wire fixation of intercarpal joints, followed by the repair of the joint capsule and special ligaments. The postoperative rehabilitation was performed.　Results　All cases were followed up about 7～24 months with an average of 15 months. The wrist function was evaluated by Cooney scores, with the mean value of 82. 8 cases were excellent, 10 cases good, 5 cases fair and 2 case poor. X-ray displayed that the fractures of scaphoid were healing by first intention and intercarpal joints were reduced. The gap between carpal bones was normal.　Conclusions　It is helpful for the recovery of wrist function using open reduction, internal fixation with pressure hollow screw and Kirschner wire, and the repair of the joint capsule and ligaments, during the treatment of trans-scaphoid perilunate fracture dislocation.

Clinical application of expansive open-door laminoplasty using CenterpieceTM titanium miniplate: an analysis of 14 cases

ZHANG Shun-Cong, JIANG Xiao-Bing, TANG Yong-Chao, LIANG De, YANG Zhi-Dong, JIN Da-Xiang, TAO Zhen-Song

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 356-358.

Abstract ( 1760 )

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Objective　To evaluate the clinical outcome of expansive open-door laminoplasty using Centerpiece Titanium Miniplate internal fixation.　Methods　14 cases with cervical spondylotic myelopathy(CSM) underwent expansive open-door laminoplasty, and CenterpieceTM plate internal fixation in C3, C5 and C7 segments. Neurological deficits pre- and post- operation were assessed using a scoring system proposed by Japanese Orthopaedic Association (JOA score).　Results　The period of follow-up lasted from 6 months to 2 years with a mean of 13.6 months. The JOA score were improved from 11.1 points pre-operation to 15.3 points at the latest follow-up(P<0.05). Reclosed open-door was not found. There were 2 cases had slight axial symptoms like neck pain and neck movement two months after the operation, and released when six months follow-up.　Conclusions　Expansive open-door laminoplasty is a reliable procedure for CSM. Centerpiece TM plate internal fixation may be an effective measure to prevent reclosed open-door and postoperative axial syndromes.

Current progress in liver segmentation and segment-oriented hepatic resection

HU Xin-Sen, WANG Rui-Chao, LIU Chang

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 359-361.

Abstract ( 1460 )

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The progress on study of organs’ decellularization

BANG Meng-Meng, MEI Jin

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 362-364.

Abstract ( 1451 )

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Diaphragma and pericardial defect accompany with the heart move to right

TAO Kang, HUANG Lu-Lu, TONG Ya-Sha, TUN Hong-Hai

Chinese Journal Of Clinical Anatomy. 2012, 30(3): 365.

Abstract ( 1150 )

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