本文選題：解剖學(xué) + 寰樞關(guān)節(jié)��； 參考：《南華大學(xué)》2005年碩士論文

【摘要】：目的 對枕寰樞復(fù)合體進(jìn)行應(yīng)用解剖學(xué)研究,為前路寰樞椎經(jīng)關(guān)節(jié)螺釘內(nèi)固定技術(shù)提供解剖學(xué)依據(jù):并探討其可行性和評價(jià)其初步臨床療效。 方法 1、標(biāo)本測量 對30具中國正常人寰樞椎骨標(biāo)本進(jìn)行解剖學(xué)測量;對5例枕頸部標(biāo)本進(jìn)行毗鄰結(jié)構(gòu)的解剖學(xué)觀察。 2、螺釘通道的設(shè)計(jì)及置釘訓(xùn)練 5例人體標(biāo)本上模擬手術(shù),并直視下在5例新鮮枕頸部標(biāo)本上置釘訓(xùn)練。螺釘固定后攝X光片,在X片上測量螺釘通道參數(shù)。并在標(biāo)本截面上測量螺釘通道與椎動脈、脊髓和枕寰關(guān)節(jié)的距離。 3、臨床初步應(yīng)用 應(yīng)用前路寰樞椎經(jīng)關(guān)節(jié)螺釘內(nèi)固定技術(shù)治療11例寰樞椎失穩(wěn)患者。 結(jié)果 1、標(biāo)本測量結(jié)果 寰椎側(cè)塊外側(cè)壁高度為18.84±0.23mm;側(cè)塊內(nèi)側(cè)壁高度為9.76±0.22mm;側(cè)塊寬度為11.03±0.23mm;側(cè)塊后1/2前后徑長度為10.09±0.14mm。樞椎椎體寬度22.4±1.2mm。螺釘通道的外斜角18°-32。和上斜角21°-30°。 2、螺釘通道的設(shè)計(jì)及置釘訓(xùn)練 ①術(shù)前設(shè)計(jì)螺釘通道的參數(shù)與實(shí)際置釘后的參數(shù)之間雙側(cè)t檢驗(yàn)顯示兩樣本均數(shù)差異無顯著性(P0.05)。②理想的釘?shù)绤?shù)是:在矢狀面上的上斜角26°;在冠狀面上的外斜角25°;釘?shù)篱L度38.4±1.8mm。③在樞椎橫突下緣的截面上,20枚螺釘與椎動脈之間距離最短,為4.7±0.12mm。在樞椎上關(guān)節(jié)面的截面上,螺釘與椎管內(nèi)壁之間距離最短,為6.27±0.13mm。螺釘與寰椎側(cè)塊上關(guān)節(jié)面之間距離為2.5±0.14mm。
[Abstract]:Objective to study the applied anatomy of occipito-atlantoaxial complex in order to provide anatomic basis for anterior atlantoaxial transarticular screw fixation. Method 1. The atlantoaxial bone specimens of 30 Chinese normal subjects were measured and the adjacent structures of 5 occipitocervical specimens were observed. (2) the design of screw passage and the training of nailing in 5 cases of human body and 5 cases of fresh occipitocervical specimen under direct vision. The screw was fixed and X-ray film was taken, and the screw channel parameters were measured on the X-ray film. The distance between the screw passage and vertebral artery, spinal cord and occipitocatlantal joint was measured on the cross section of the specimen. 3. 11 cases of atlantoaxial instability were treated with anterior transarticular screw fixation. Result 1. The lateral wall height of lateral mass of atlas was 18.84 鹵0.23 mm, the height of lateral wall was 9.76 鹵0.22 mm, the width of lateral mass was 11.03 鹵0.23 mm, and the length of anterior and posterior diameter of 1 / 2 of lateral mass was 10.09 鹵0.14 mm. The width of the axial vertebral body was 22.4 鹵1.2 mm. The external angle of the screw passage is 18 擄-32. And the upper angle is 21 擄-30 擄. 2. Design of screw passage and training of screw insertion 1 bilateral t test showed that there was no significant difference in the mean of the two samples between the parameters of the designed screw channel before operation and the parameters after actual nailing. The ideal parameters of the two samples were as follows: in sagittal plane, there was no significant difference in the mean of the two samples. The upper oblique angle is 26 擄, the external slope angle is 25 擄on the coronal plane, the length of the nail canal is 38.4 鹵1.8mm.3, and the distance between 20 screws and vertebral artery is the shortest in the section of the inferior edge of the transverse process of axis. It was 4.7 鹵0.12mmm. The distance between the screw and the inner wall of the spinal canal was the shortest (6.27 鹵0.13 mm) on the cross section of the superior articular surface of the axis. The distance between the screw and the superior articular surface of the lateral mass of atlas was 2.5 鹵0.14 mm.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2005
【分類號】：R687.3;R322

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