Naderi S, Usal C, Tural A N, Korman E, Mertol T, Arda M N
Department of Neurosurgery, Dokuz Eylül University, School of Medicine, Izmir, Turkey.
J Spinal Disord. 2001 Dec;14(6):500-3. doi: 10.1097/00002517-200112000-00006.
Several diseases may cause craniovertebral instability warranting occiput-cervical fusion. As occipital screw and rod constructs are becoming more popular, requiring that screws be placed either medially or laterally in the occipital bone, the need for clearer anatomical and computed tomography (CT)-confirmed data regarding the relative thickness of the occiput in its various localities has become more critical. In 18 cadaveric specimens, the occipital bone was divided into 35 measurable segments. Transversely, the occipital bone was divided into five lines starting at the level of the inion; horizontal lines then proceeded inferiorly in 1-cm segments, 1, 2, 3, and 4 cm below the level of inion. In a comparable fashion, the occipital bone was divided vertically, starting at the midline, and proceeding laterally also in 1-, 2-, and 3-cm segments. Anatomical measurements of thickness were directly performed using a Vernier caliper. Results were directly correlated with axial CT measurements of bony thickness. Anatomical and CT measurements closely correlated within the same specimen, but there was significant interspecimen variability. The marked differences in the occipital bone anatomy noted between specimens indicates that patients undergoing occipital screw placement for cranial-cervical instability would benefit from preoperative occipital CT evaluations.
几种疾病可能导致颅颈不稳，需要进行枕颈融合术。随着枕骨螺钉和棒状结构越来越受欢迎，这要求将螺钉放置在枕骨的内侧或外侧，因此对于枕骨不同部位相对厚度的更清晰的解剖学和计算机断层扫描（CT）确认数据的需求变得更加迫切。在18个尸体标本中，枕骨被分为35个可测量的节段。横向地，枕骨从枕外隆凸水平开始被分为五条线；然后水平线以1厘米的节段向下延伸，在枕外隆凸水平以下1厘米、2厘米、3厘米和4厘米处。以类似的方式，枕骨从正中线开始垂直划分，并也以1厘米、2厘米和3厘米段向外侧延伸。使用游标卡尺直接进行厚度的解剖学测量。结果与骨厚度的轴向CT测量直接相关。在同一标本中，解剖学测量和CT测量密切相关，但标本间存在显著差异。标本之间枕骨解剖结构的明显差异表明，因颅颈不稳接受枕骨螺钉置入的患者将从术前枕骨CT评估中受益。
