【摘要】 目的通过解剖观察和测量国人寰齿关节以获取形态学参数,为研制能替代寰齿关节功能的人工寰齿关节提供解剖数据。方法用电子游标卡尺和量角器测量32套正常成年人寰齿关节新鲜标本的相关参数,包括寰椎前弓宽度(AW)、寰椎前弓与侧块相连处厚度(AD)、寰椎前结节厚度(AT)和高度(AH)、寰椎侧块中点高度(MHL)和长度(L)、寰椎侧块宽度(LW)、齿状突高度(DH)、齿状突横径(DW)和前后径(DD)、齿状突后倾角(β)和齿面角(θ)等19项内容。并进行统计学分析,为研制人工寰齿关节提供形态学参数范围。据此设计仿生人工寰齿关节,在3具成人尸体标本进行模拟人工寰齿关节置人手术。结果测得AW为(20．45±1．53)mm、AD为(3．91±1．32)mm、AT和AH分别为(9．43±1．93)mm和(10．23±1．32)mm、MHL和LW分别为(13．68±1．38)mm和(12．98±1．52)mm、DH为(15．25±2．11)mm、DW和DD分别为(9．69±1．38)mm和(11．26±1．02)mm、齿状突后倾角(β)为(12．23±4．27)°,齿面角(θ)为(65．48±2．17)°。人工关节由寰椎部件、枢椎部件和配件构成。模拟手术中无椎动脉损伤和假体压迫脊髓。结论人工寰齿关节的研制在形态学上具有可行性；人工寰齿关节的研制是既能重建寰枢关节稳定性,又能最大限度地保留寰枢关节旋转功能的可行性技术；为了安放牢固、操作方便、保持运动功能以及避免副损伤,各部件参数有一定的选取范围,适用于一切需做前路齿突切除减压的患者。更多还原

【Abstract】 Objective To observe and measure atlanto-odontoid joint for obtaining parameters of morphology in Chinese people via anatomy so as to provide anatomic data for designing artificial anlanto- odontoid joint.Methods Digital caliper and a goniometer were used to measure the relative anatomic parameters of 32 sets of fresh Chinese aduhs’atlanto-odontoid joint specimens including width of anterior arch of atlas(AW),thickness of atlas at the junction of anterior arch and lateral mass(AD),thickness and height of anterior tubercle of atlas(AT and AH),middle height,length and width of the lateral mass (MHL,L and LW),height,transverse distance and anteriorposterior distance of odontoid process(DH, DW and DD),retroversion angle of odontoid process(β)and facial angle of odontoid process(θ).The data were statistically analyzed in order to ascertain the morphological parameter range of artificial anlanto- odontoid joint,based on which an artificial anlanto-odontoid joint could be designed.The operation of an- lanto-odontoid joint arthroplasty was conducted in three adult cadaver specimens. Results Measure- ment results showed that AW was for(20.45±1.53)mm,AD for(3.91±1.32)mm,AT for(9.43±1.93)mm,AH for(10.23±1.32)mm,MHL for(13.68±1.38)mm,LW for(12.98±1.52)mm,the height distance of odontoid process for(15.25±2.11)mm,the transverse and anteriorposterior distance of odontoid process for(9.69±1.38)mm and(11.26±1.02)mm respectively,the retrovcrsion angle of odontoid process for(12.23±4.27)~°and the facial angle of odontoid process for(65.48±2.17)~°.The prosthesis was composed of arias part,axis part and accessories.No injury was found on the vertebral ar- tery or medullary oblongata.Conclusions The designation of artificial anlanto-odontoid joint is feasible in as morphology.The artificial joint can not only rebuild the stability of atlanto-axial joint,but also res- erve the rotation function between atlas and axis.Every part of the joint has their own parameter ranges for firm fixation,convenient operation and good motion without further injury.The prosthesis can be used for patient suffering from compression of medullary oblongata and requiring resection of dens.更多还原