Wang Sheng-Lin, Wang Chao, Yan Ming, Zhou Hai-Tao, Dang Geng-Ting
Department of Orthopaedics, Third Hospital of Peking University, Beijing 100083, China.
Zhonghua Wai Ke Za Zhi. 2008 Jan 15;46(2):115-7.
To evaluate the veracity of the C1 lateral mass screw insertion in the atlantoaxial fixation using plate and screw method without A-P fluoroscopic guiding.
In the atlantoaxial fixation, without A-P fluoroscopic guiding, we probe lateral mass edge and identify the entrance point of C1 lateral mass screw indirectly. 159 patients treated with atlantoaxial fixation using plate and screw method were studied. Postoperative CT was used for analysis, and the position of the lateral mass screws in atlas was identified by coronary and axial CT scan. Three areas were delimited in and around the lateral mass of atlas in the axial CT scan, so as to analyze the location of screws: area A (inside the joint face), area B (outside the joint face but still in lateral mass), and area C (outside the lateral mass).
Among the 318 screws, 308 (96.9%) were located in area A, 5 in area B (1.6%), and 5 in area C (1.6%). All cases got atlantoaxial union at 4 months after operation.
Probing lateral mass edge and identifying the lateral mass indirectly is reliable for identifying the path of screw in atlas.
评估在无前后位透视引导下使用钢板螺钉法进行寰枢椎固定时C1侧块螺钉置入的准确性。
在无前后位透视引导的寰枢椎固定中，我们探查侧块边缘并间接确定C1侧块螺钉的进针点。对159例行钢板螺钉法寰枢椎固定的患者进行研究。术后使用CT进行分析，通过冠状位和轴位CT扫描确定寰椎侧块螺钉的位置。在轴位CT扫描中，在寰椎侧块及其周围划定三个区域，以分析螺钉的位置：A区（关节面内）、B区（关节面外但仍在侧块内）和C区（侧块外）。
在318枚螺钉中，308枚（96.9%）位于A区，5枚位于B区（1.6%），5枚位于C区（1.6%）。所有病例术后4个月均实现寰枢椎融合。
探查侧块边缘并间接确定侧块对于确定寰椎螺钉路径是可靠的。
