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目的:寻求前路经寰枢关节螺钉内固定行枕颈融合可行性的解剖学依据。方法:对30例正常国人行枕寰枢区三维CT重建,测量与内固定有关的解剖径线长度及角度大小,观察舌下神经管与枕骨髁的相对位置关系;并以测得的数据为依据在8具人体干燥枕寰枢标本上行螺钉内固定,三维CT检查内固定位置。结果:枕骨髁关节面的宽度为11.23～17.08mm,后1/3宽度为3.74～5.69mm,寰椎上关节面的长度为11.65～20.71mm,枕骨髁高度为4.30～10.62mm,舌下神经管的位置相对恒定,表明枕颈部解剖结构适于行前路枕颈融合术;内固定后三维CT检查未见毗邻组织损伤。结论:前路经寰枢关节螺钉内固定行枕颈融合在解剖上是可行的,舌下神经管与枕骨髁的位置关系相对恒定,但少部分舌下神经管位于枕骨髁的后外侧,会使进针变得危险。
OBJECTIVE: To seek the anatomic evidence for the feasibility of occipitocervical fusion with anterior atlantoaxial screw fixation. Methods: Thirty patients with normal people underwent three-dimensional computed tomography (CT) reconstruction of the occipital atlantoaxial region. The length of the anatomical line and the angle of the anatomy were measured. The relative position between the hypoglossal canal and the occipital condyles was observed. The measured data were Based on the eight human dry pillow atlantoaxial screw fixation, three-dimensional CT examination of the internal fixation. Results: The width of the articular surface of the occipital condyle was 11.23-17.08 mm, the width of the posterior 1/3 was 3.74-5.69 mm, the length of the atlantoaxial articular surface was 11.65-20.71 mm, and the height of the occipital condyles was 4.30-10.62 mm. The hypoglossal nerve The position of the tube was relatively constant, indicating that the occipital and cervical anatomy was suitable for the anterior occipitocervical fusion. There was no adjacent tissue damage in the three-dimensional computed tomography after internal fixation. Conclusion: Anterior atlantoaxial arthrodesis is an anatomically feasible method for the fusion of the occipitocervix and neck. The relationship between the hypoglossal canal and the occipital condyles is relatively constant, but a small portion of the hypoglossal canal is located posteriorly to the occipital condyle. Make the needle dangerous.