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[1]周樹一,許楠健,王揚(yáng),等.后路經(jīng)寰枕關(guān)節(jié)-枕骨髁-斜坡置釘技術(shù)的可行性和安全性研究[J].中醫(yī)正骨,2022,34(12):8-13.
　ZHOU Shuyi,XU Nanjian,WANG Yang,et al.Feasibility and safety of posterior atlantooccipital joint-occipital condyle-clivus screw fixation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(12):8-13.
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后路經(jīng)寰枕關(guān)節(jié)-枕骨髁-斜坡置釘技術(shù)的可行性和安全性研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年12期
頁碼:
8-13
欄目:
基礎(chǔ)研究
出版日期:
2022-12-02

文章信息/Info

Title:
Feasibility and safety of posterior atlantooccipital joint-occipital condyle-clivus screw fixation
作者:
周樹一1; 許楠健1; 王揚(yáng)1; 施凱日1; 趙旭晨2; 華鵬程2; 馬維虎1
(1.寧波市第六醫(yī)院,浙江 寧波 315040; 2.寧波大學(xué)醫(yī)學(xué)院,浙江 寧波 315211)
Author(s):
ZHOU Shuyi1; XU Nanjian1; WANG Yang1; SHI Kairi1; ZHAO Xuchen2; HUA Pengcheng2; MA Weihu1
1.Ningbo No.6 Hospital,Ningbo 315040,Zhejiang,China; 2.School of Medicine,Ningbo University,Ningbo 315211,Zhejiang,China
關(guān)鍵詞:
脊柱融合術(shù);  寰枕關(guān)節(jié);  枕骨;  解剖學(xué);  影像學(xué)檢查;  可行性研究;  安全性研究
Keywords:
spinal fusion;  atlanto-occipital joint;  occipital bone;  anatomy;  imaging examination;  feasibility studies;  safety studies
摘要:
目的:探討后路經(jīng)寰枕關(guān)節(jié)-枕骨髁-斜坡置釘技術(shù)的可行性與安全性。方法:收集12具包含完整上頸椎骨性結(jié)構(gòu)的新鮮冰凍尸體頭顱標(biāo)本,直視下將直徑2.0 mm的克氏針經(jīng)寰枕關(guān)節(jié)-枕骨髁-斜坡植入標(biāo)本后,拍攝X線片并測(cè)量克氏針釘?shù)李^傾角、內(nèi)傾角; CT掃描標(biāo)本,重點(diǎn)觀察克氏針是否經(jīng)過寰枕關(guān)節(jié),是否在斜坡內(nèi),是否穿破寰椎內(nèi)側(cè)壁及枕骨髁內(nèi)外側(cè)壁,是否侵入舌下神經(jīng)管、椎動(dòng)脈孔、蝶竇; 解剖標(biāo)本,重點(diǎn)觀察寰椎側(cè)塊、枕骨髁內(nèi)外側(cè)骨質(zhì)有無破損,克氏針是否侵入舌下神經(jīng)管、是否突破斜坡兩側(cè)及上部的骨質(zhì); 拔出克氏針,用電子游標(biāo)卡尺測(cè)量克氏針進(jìn)入骨組織的部分即釘?shù)篱L(zhǎng)度。結(jié)果:12具標(biāo)本的克氏針釘?shù)纼?nèi)傾角20.29°±3.10°,釘?shù)李^傾角53.51°±4.61°,釘?shù)篱L(zhǎng)度(52.03±1.02)mm; 左、右側(cè)釘?shù)纼?nèi)傾角、頭傾角及長(zhǎng)度比較,差異均無統(tǒng)計(jì)學(xué)意義[20.23°±3.35°,20.34°±2.98°,t=-0.523,P=0.611; 53.45°±4.64°,53.57°±4.79°,t=-0.496,P=0.630;(51.93±1.15)mm,(52.12±0.92)mm,t=-1.161,P=0.270]。CT掃描結(jié)果顯示,克氏針均經(jīng)過寰枕關(guān)節(jié)且均在斜坡骨質(zhì)內(nèi),均未穿破寰椎內(nèi)側(cè)壁及枕骨髁內(nèi)外側(cè)壁,均未侵入舌下神經(jīng)管、椎動(dòng)脈孔、蝶竇。標(biāo)本解剖后觀察結(jié)果顯示,寰椎側(cè)塊、枕骨髁內(nèi)外側(cè)骨質(zhì)均無破損,克氏針均未侵入舌下神經(jīng)管、均未突破斜坡兩側(cè)及上部的骨質(zhì)。結(jié)論:后路經(jīng)寰枕關(guān)節(jié)-枕骨髁-斜坡置釘技術(shù)在解剖學(xué)和影像學(xué)上具有可行性和安全性,可作為后路枕頸融合術(shù)的補(bǔ)充。
Abstract:
Objective:To investigate the feasibility and safety of posterior atlantooccipital joint-occipital condyle-clivus screw fixation.Methods:Twelve fresh frozen cadaveric skull specimens containing complete upper cervical spine were collected.Under direct vision,2.0 mm diameter Kirschner wires were implanted into the specimens through the atlantooccipital joint-occipital condyle-clivus,followed by X-ray imaging and the measurement of head tilting and leaning angle of the Kirschner wire trajectory.CT scan was performed to observe whether Kirschner wires passed through the atlantooccipital joint,whether they were in the clivus,whether they broke the medial wall of the atlas and the lateral wall of the occipital condyle,and whether they invaded the hypoglossal canal,vertebral foramina,and sphenoid sinus.The specimens were dissected to primarily observe whether the lateral atlas and the medial and lateral bones of the occipital condyle were damaged,whether Kirschner wires invaded the hypoglossal canal,and whether Kirschner wires broke through the bones on both sides and upper part of the clivus.The Kirschner wires were withdrawn and an electronic caliper was employed to measure the distance of Kirschner wire trajectory in the bone tissues.Results:The leaning angle and head tilting angle of the Kirschner wire trajectory of the 12 specimens were 20.29°±3.10° and 53.51°±4.61°,and the distance of trajectory was(52.03±1.02)mm.There was no significant difference in the leaning angle and head tilting angle,as well as distance of left and right trajectories(20.23°±3.35° vs 20.34°±2.98°,t=-0.523,P=0.611; 53.45°±4.64° vs 53.57°±4.79°,t=-0.496,P=0.630; 51.93±1.15 vs 52.12±0.92 mm,t=-1.161,P=0.270).As revealed by CT scan,all Kirschner wires passed through the atlantooccipital joint and were in the clivus,without penetrating the medial wall of the atlas and the lateral wall of the occipital condyle,and without invading the hypoglossal canal,vertebral foramina,and sphenoid sinus.The anatomical results of the specimens showed that lateral atlas and the medial and lateral bones of the occipital condyle were not damaged,and Kirschner wires did not invade the hypoglossal canal or break through the bones on both sides and the upper part of the clivus.Conclusion:The posterior atlantooccipital joint-occipital condyle-clivus screw fixation technique is feasible and safe in anatomy and imaging,and can be used as a supplement to posterior occipitocervical fusion.

參考文獻(xiàn)/References:

[1] BHIMANI A D,CHIU R G,ESFAHANI D R,et al.C1-C2 fusion versus occipito-cervical fusion for high cervical fractures:a multi-institutional database analysis and review of the literature[J].World Neurosurg,2018,119:e459-e466.
[2] KINOSHITA H,MIYAKOSHI N,KOBAYASHI T,et al.A case report of revision occipital-cervical fusion after atlanto-axial instrumentation failure for neurofibromatosis type Ⅰ[J].BMC Surg,2019,19(1):44.
[3] VENDER J R,REKITO A J,HARRISON S J,et al.The evolution of posterior cervical and occipitocervical fusion and instrumentation[J].Neurosurg Focus,2004,16(1):E9.
[4] GROB D.Posterior occipitocervical fusion in rheumatoid arthritis and other instabilities[J].J Orthop Sci,2000,5(1):82-87.
[5] LAVANO A,GUZZI G,STROSCIO C A,et al.Occipitocervical fusion[J].Acta Neurochir Suppl,2019,125:243-245.
[6] 周樹一,李豪杰,王揚(yáng),等.上頸椎后路內(nèi)固定技術(shù)的研究進(jìn)展[J].中醫(yī)正骨,2020,32(11):24-28.
[7] BURTSEV A V,SERGEENKO O M,GUBIN A V.An alternative way of C1 screwing:supralaminar C1 lateral mass screws[J].J Craniovertebr Junction Spine,2021,12(2):191-196.
[8] 王揚(yáng),李豪杰,周樹一,等.寰椎椎弓根螺釘聯(lián)合經(jīng)寰樞關(guān)節(jié)螺釘內(nèi)固定穩(wěn)定性的生物力學(xué)研究[J].中國(guó)脊柱脊髓雜志,2021,31(12):1129-1135.
[9] 吳超,鄧佳燕,譚倫,等.逐級(jí)擴(kuò)大型3D打印導(dǎo)板系統(tǒng)輔助寰樞椎椎弓根植釘準(zhǔn)確性分析及臨床應(yīng)用[J].中國(guó)修復(fù)重建外科雜志,2019,33(2):212-218.
[10] LEE Y M,LU A Y,OH T,et al.C2 translaminar screw fixation in pediatric occipitocervical fusion[J].Childs Nerv Syst,2022,38(6):1125-1135.
[11] NAGATA K,BABA S,CHIKUDA H,et al.Use of C2 spinous process screw for posterior cervical fixation as substitute for laminar screw in a patient with thin laminae[J/OL].BMJ Case Rep,2013,2013:bcr2013009889[2022-03-12].https://pubmed.ncbi.nlm.nih.gov/23814004/.
[12] 馬生輝,馮煜,管江衡,等.齒狀突切除術(shù)后前路與后路C1～C2經(jīng)關(guān)節(jié)螺釘內(nèi)固定的生物力學(xué)分析[J].中國(guó)臨床神經(jīng)外科雜志,2020,25(10):696-700.
[13] IZEKI M,NEO M,FUJIBAYASHI S,et al.Utility of the analysis of intracranial venous sinuses using preoperative computed tomography venography for safe occipital screw insertion[J].Spine(Phila Pa 1976),2013,38(18):E1149-1155.
[14] SUCHOMEL P,BUCHVALD P,BARSA P,et al.Single-stage total C-2 intralesional spondylectomy for chordoma with three-column reconstruction.Technical note[J].J Neurosurg Spine,2007,6(6):611-618.
[15] 嚴(yán)望軍,周許輝,張?jiān)?等.后路經(jīng)寰枕關(guān)節(jié)螺釘內(nèi)固定的解剖學(xué)研究[J].中華骨科雜志,2006,26(1):35-38.
[16] 李國(guó)慶,馬維虎,孫韶華,等.后路枕骨髁螺釘通道的影像解剖學(xué)研究[J].中華創(chuàng)傷雜志,2015,31(3):273-277.
[17] 王揚(yáng),馬維虎,李國(guó)慶,等.后路枕骨髁螺釘置釘參數(shù)對(duì)安全性的影響[J].中華骨科雜志,2017,37(10):587-594.
[18] 程杭清,馬維虎,王揚(yáng),等.后路枕骨髁螺釘內(nèi)固定系統(tǒng)的生物力學(xué)研究[J].中國(guó)脊柱脊髓雜志,2018,28(1):73-78.
[19] 馬維虎,王揚(yáng),婁楨祺,等.枕骨髁螺釘治療上頸椎不穩(wěn)的有限元分析[J].中華創(chuàng)傷雜志,2018,34(4):305-311.
[20] 吳玉學(xué),呂青,于龍廣,等.人體斜坡區(qū)斷層解剖及三維重建研究[J].局解手術(shù)學(xué)雜志,2018,27(2):79-82.
[21] 周樹一,許楠健,李豪杰,等.后路寰枕關(guān)節(jié)-枕骨髁-斜坡置釘技術(shù)的數(shù)字化解剖學(xué)研究[J].中華醫(yī)學(xué)雜志,2021,101(25):1973-1977.
[22] 李豪杰,馬維虎,彭宇杰,等.經(jīng)關(guān)節(jié)斜坡螺釘內(nèi)固定技術(shù)的生物力學(xué)研究[J].中華骨科雜志,2021,41(16):1100-1107.
[23] 高坤,余正紅,邵佳,等.顱頸交界不穩(wěn)定3D打印導(dǎo)向器輔助枕頸融合術(shù)[J].中國(guó)矯形外科雜志,2021,29(21):1978-1981.
[24] 馬維虎.上頸椎骨折手術(shù)技術(shù)的選擇與應(yīng)用[J].中華創(chuàng)傷雜志,2019,35(11):966-969.
[25] 董瑞一,朱仕文,蘇永剛.TiRobot輔助骨折手術(shù)的應(yīng)用進(jìn)展[J].中華創(chuàng)傷骨科雜志,2022,24(2):179-184.
(收稿日期:2022-05-26 本文編輯:時(shí)紅磊)

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備注/Memo

備注/Memo:
基金項(xiàng)目:浙江省醫(yī)藥衛(wèi)生科技計(jì)劃項(xiàng)目(2020391275); 寧波市科技計(jì)劃項(xiàng)目(202003N4299); 寧波市鄞州區(qū)農(nóng)業(yè)與社會(huì)發(fā)展科技項(xiàng)目(2020AS0074) 通訊作者:馬維虎 E-mail:[email protected]
更新日期/Last Update: 1900-01-01