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目的:研究枢椎椎弓根-关节突复合体的解剖结构特征,探讨该解剖概念的临床意义。方法:观察80具枢椎干骨标本椎弓根-关节突部位的解剖结构特征。并随机抽取其中20具标本,在椎弓骨背侧表面做枢椎经椎弓根螺钉固定及经关节(C1-2)螺钉固定钉道投影画线,另2具标本按两种螺钉内固定方式设置直径3.5 mm钉道,并螺旋CT扫描多平面重建(MPR)钉道断面影像,了解两种钉道与椎弓根-关节突结构的解剖关系。回顾性分析25例外伤致枢椎椎弓根-关节突部位骨折的CT资料,包括其中12例枢椎螺钉内固定术后CT,研究该部位骨折特点及钉道所在的断面解剖。结果:枢椎解剖学上,无严格定义下完整的椎弓根。而枢椎椎弓根-关节突作为复合体,具有解剖结构上整体性特征,其周围界线清楚。外伤致枢椎椎弓根-关节突复合体骨折可分为椎弓根-上关节突骨折、关节突间部骨折及单纯上关节突骨折。枢椎经椎弓根螺钉固定及经关节(C1-2)螺钉内固定的钉道均通过椎弓峡部中心,但起点不同,走向不同。结论:枢椎椎弓根-关节突复合体作为临床解剖概念,具有解剖结构的完整性。明确该解剖概念及各构件对该区域骨折分类与螺钉内固定手术具有指导意义。
OBJECTIVE: To study the anatomic features of the pedicle-facet joint complex and to explore its clinical significance. Methods: The anatomical features of the pedicle - facet joint in 80 specimens with axial bone were observed. And randomly selected 20 of them, in the dorsal surface of the vertebral arch made by the pedicle screw fixation and through the joint (C1-2) screw fixation Dingdao projection line, the other two specimens by two kinds of screw fixation Methods A diameter of 3.5 mm was established and spiral CT scan MPR pinhole cross section images were obtained to understand the anatomic relationship between the two kinds of pedicle screw and the pedicle - facet joint structure. The CT data of 25 patients with traumatic pedicle screw fracture were analyzed retrospectively. Including 12 cases of CT after internal fixation of the pedicle screws, the fracture characteristics of the part and the sectional anatomy of the pedicle screw were studied. Results: Axis anatomy, there is no strict definition of complete pedicle. The pedicle - facet joint as a complex, with the overall anatomical features, the boundaries clear boundaries. Traumatic fractures of the pedicle of the pedicle-facet joint can be divided into pedicle-facet joint fractures, facet joint fractures, and simple superior articular fractures. Axillary pedicle screw fixation and intra-articular (C1-2) screw fixation through the pedicle isthmus center, but the starting point is different, to different. CONCLUSIONS: Axonal pedicle-facet complex as an anatomical concept with anatomic integrity. To clarify the anatomy of the concept and the components of the classification of the fracture and screw fixation has instructive significance.