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目的通过60具寰椎标本的观察和测量,建立经口前路寰椎椎弓根螺钉的置钉技术。方法60具成年人体寰椎干骨标本,观察并确定前路寰椎椎弓根螺钉的安全进钉点,测量其与寰椎上关节面、前正中矢状面及与横突孔内侧壁的距离,寰椎侧块宽度,侧块长度,前路寰椎椎弓根螺钉的骨性钉道长度,椎弓根厚度,安全的进钉方向(向外倾斜角度)。结果经口前路寰椎椎弓根螺钉的安全进钉点为:与前正中矢状面的距离为(14.1±1.0)mm,寰椎侧块长度为(20.8±2.8)mm,宽度(19.6±2.4)mm;与横突孔内侧壁的距离为(10.1±2.0)mm。前路寰椎椎弓根的骨性钉道长度为(28.8±1.8)mm,椎弓根的高度为(5.6±0.8)mm。安全置钉方向为向外倾斜(9°±3°)。结论①经口前路寰椎椎弓根螺钉的最佳进钉点为距离前正中失状面14mm处;②安全进钉方向为向外倾斜9°置入的寰椎椎弓根螺钉均位于骨性钉道内,安全可靠。
Objective To establish an anterior staple atlas pedicle screw fixation through observation and measurement of 60 atlas specimens. METHODS: Sixty adult adult atlantoaxial bone specimens were obtained. The anterior approach of the atlas pedicle screw was observed and confirmed. The mean diameter of the atlas pedicle screw was measured. Distance, atlas lateral mass, lateral mass, anterior cruciate pedicle screw length, vertebral pedicle thickness, and safe entry direction (outward tilt angle). Results The anterior approach of pedicle screw fixation was (14.1 ± 1.0) mm in the anterior median sagittal plane, (20.8 ± 2.8) mm in lateral mass and 19.6 ± 2.4) mm; the distance from the lateral wall of the transverse foramen was (10.1 ± 2.0) mm. The length of the pedicle screw in the anterior atlas pedicle was (28.8 ± 1.8) mm and the pedicle height was (5.6 ± 0.8) mm. Safety pinning direction is outwardly inclined (9 ° ± 3 °). Conclusions ① The optimal entry point of pedicle screw in anterior anterior approach is 14mm away from the anterior median hyperplasia surface. ② The pedicle screws of atlas pedicle screw placed safely outward in 9 ° outward direction Bony nails, safe and reliable.