中国骨伤Issue(9)：772-774,3.DOI:10.3969/j.issn.1003-0034.2014.09.014
椎动脉的解剖研究及在上颈椎椎弓根置钉中的应用
Anatomical study on vertebral artety and its application in transpedicle screw fixation for upper cervical vetebrae
摘要
Abstract
Objective:To investigate the relationship of upper cervical pedicle and vertebral artery (VA) location in or-der to improve the safety of transpedicular screw insertion. Methods:The vertebral arteries on 12 sides of 6 adult pate cadav-erous specimens were dissected. The distance between VA and VA groove at the atlas needling point of transpedicle screw ,and the distance between VA and the inner edge of axis cervical foramen ,and the VA external diameter in axis cervical foramen were measured respectively. Results:The distance between VA and VA groove was (1.96±0.72) mm on the left and (1.99± 0.61)mm on the right at the atlas needling point of transpedicle screw ,the distance between VA and the inner edge of axis cer-vical foramen was (2.23±0.43) mm on the left and (2.30±0.39) mm on the right,the VA external diameter in axis cervical foramen was (3.03±0.48) mm on the left and (2.98±0.75) mm on the right. Conclusion:It is unlikely to injury VA when the transpedicle screws of upper cervical vertebrae were implanted correctly besides high straddled VA ,and the individualization must be performed in the process.关键词
椎动脉/寰椎/枢椎/内固定/解剖Key words
Vertebral artety/Atlas/Axis/Internal fixation/Dissection引用本文复制引用
武兴国,黄健,蒋煜青,郭伟康,王军..椎动脉的解剖研究及在上颈椎椎弓根置钉中的应用[J].中国骨伤,2014,(9):772-774,3.基金项目
广东省卫生厅基金课题（编号B2012377）Fund programFoundation Topic of Guangdong Health Department （No． B2012377）上颈椎不稳的后路短节段固定方法较多，寰枢椎椎弓根螺钉固定的生物力学强度和经寰枢椎关节突Magerl 螺钉联合Gallie 钢丝或Brooks 钢丝的固定相当，并明显优于椎板下钢丝和椎板钩。但是由于寰枢椎椎弓根紧邻椎动脉，此部分椎动脉的医源性损伤导致的并发症是灾难性的，包括出血、血栓、栓子形成、脑缺血、动静脉瘘以及假性动脉瘤，相关的解剖变异使这种损伤的发生率增加，为了确保上颈椎手术的安全，有必要对其解剖结构和变异情况进 （）
