Amling M, Hahn M, Wening V J, Grote H J, Delling G
Department of Bone Pathology, Universitäts-Krankenhaus Eppendorf, University of Hamburg, Germany.
J Bone Joint Surg Am. 1994 Dec;76(12):1840-6. doi: 10.2106/00004623-199412000-00011.
The axis from twenty-two cadavera was removed at autopsy and was sectioned in the sagittal plane to a thickness of one millimeter with use of a surface-stained block-grinding technique. Combined two and three-dimensional analysis included an evaluation of the volume of the trabecular bone, the trabecular interconnection, and the cortical thickness as well as qualitative investigation of the structure of the cancellous bone. The body of the axis, the base of the odontoid process, and the odontoid process were analyzed separately. The base of the odontoid process is a region of least resistance for fractures because of its unique microarchitecture. The mean volume of trabecular bone of the base of the odontoid process is 55 per cent less than that of the axis and the odontoid process. The base also has a markedly poorer trabecular interconnection and a cortical thickness that is one-third that of the odontoid process. In all of the specimens, trabeculae that were disconnected from the trabecular lattice (trabeculae with free ends) were demonstrated in the base of the odontoid process. The formation of microcallus in six (27 per cent) of the specimens supports the hypothesis that microfractures occur as a result of stress peaks, mechanical fatigue, and the relative insufficiency of bone in the static condition. Therefore, the base of the odontoid process can be considered as a site of predilection for fractures.
在尸检时从22具尸体上取下枢椎，并使用表面染色块研磨技术在矢状面将其切成1毫米厚的切片。二维和三维联合分析包括对松质骨体积、小梁连接性、皮质厚度的评估，以及对松质骨结构的定性研究。分别对枢椎体、齿突基部和齿突进行分析。齿突基部因其独特的微观结构，是骨折的阻力最小区域。齿突基部的松质骨平均体积比枢椎体和齿突的小55%。该基部的小梁连接性也明显较差，皮质厚度仅为齿突的三分之一。在所有标本中，在齿突基部均可见与小梁网络分离的小梁（有自由端的小梁）。6个（27%）标本中出现微骨痂形成，支持了微骨折是由应力峰值、机械疲劳以及静态条件下骨相对不足导致的这一假说。因此，齿突基部可被视为骨折的好发部位。
