国人枕骨髁螺钉内固定术的应用解剖学分析

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1、钉点：枕骨髁后方内外侧中点，颅底下方约2mm处；进钉角度：与颅底平行，内倾(32.23±4.23)°，范围25.23°~38.54°；进钉长度(21.36±3.54)mm，范围为17.35mm~25.63mm。螺钉均位于枕骨髁内，位置良好，未穿破骨皮质，无舌下神经管损伤。4．模拟手术操作：在12例（24侧）枕骨干燥标本上模拟枕骨髁螺钉理想置钉通道进行置钉，结果发现，24枚枕骨髁螺钉位置良好，枕骨髁能完全容纳直径为3.5mm的螺钉，骨质内螺钉植入长度为(20.10±2.11)mm，范围为17.51mm~2

2、5.02mm，没有损伤舌下神经管；6例人体标本上进行枕颈固定融合手术的模拟手术，术后颈椎正侧位片及CT扫描结果显示：枕骨髁螺丝钉位置良好，均位于枕骨髁内，位置良好，未穿破骨皮质，无舌下神经管损伤。结论1．国人行枕骨髁螺钉内固定术具有可行性，由于枕骨髁的解剖特点个体差异较大，建议术前对枕骨髁进行详细的影像学调查及个性化的手术规划。2．国人枕骨髁螺钉的进钉点选择枕骨髁后方内外侧中点，颅底下方约2mm处；进钉角度向上或向下与颅底成角不超过10°，内倾(32.58±3.83)°，范围24.31°~42.62°；

3、枕骨髁内可植入的螺钉长度(21.55±2.48)mm，范围为16.52mm~26.52mm；枕骨髁螺钉的规格为直径3.5mm~4.0mm、长度26mm~40mm的半螺纹皮质骨钉和松质骨钉。关键词枕骨髁舌下神经管枕骨髁螺钉枕颈融合应用解剖学III万方数据TheclinicalappliedanatomystudyofoccipitalcondylescrewfixationAbstractObjectiveInvestigatethefeasibilityofChinesepeople’soccipita

4、l-cervicalfusionsurgerywithOccipitalcondylescrewfixation,proposedthechannelparametersandthespecificationofChinesepeopleoccipitalcondylescrew.Methods1、TheAnatomyobserveandmeasurements:Obtaintheoccipitalherbarium60cases,theywereclassifiedaccordingtothecond

5、ylarshapeinaccordancewiththeclassificationcriteriaoftheOzerMA’s;andthenmeasuretheoccipitalcondylelength,occipitalcondylewidth,occipitalcondyleheightandtheoccipitalcondyleinclinationangle.2、Theoccipitalcondyleimagingmeasurement:randomsampleof40casesCTdata

6、ofpatients.Measuringthelength,width,heightoftheoccipitalcondyles,andtheoccipitalcondyleinclinationangle.3、Digitaltechnologyanalogpediclescrews:6freshhumanspecimens,continuouslineoccipitalCTscandata,scandataisstoreddirectlytotheDICOM3.0standardestablishth

7、eoccipitalcondyledatafile,andthentakethecontinuousCTscandataintoMimicssoftware,surgicalsimulationofpediclescrews.4、Operationofanalogsurgery:Usetwelvecases(twenty-foursides)occipitalcondylesherbariumanalogoccipitalcondylescrewidealpediclescrew,Measurethel

8、engthofthebonescrewobservethescrewswithorwithoutperforationcondylecorticalbonearound,whetherinjuryhypoglossalcanal;Andusesixcasesoffreshheadandneckspecimensafterredlatexperfusion,thanthree-dimensionalCTscan.measurethelengt