A neurosurgical view of anatomical evaluation of anterior C1-C2 for safer transoral odontoidectomy
A neurosurgical view of anatomical evaluation of anterior C1-C2 for safer transoral odontoidectomy
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DOI：
10.1007/s00586-008-0647-4
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发表时间：
2008-06-01
影响因子：
2.8
通讯作者：
Elhan, Alaiddin
中科院分区：
文献类型：
--
作者：
Tun, Kagan;Kaptanoglu, Erkan;Elhan, Alaiddin
评价C1-C2前路的解剖学研究。目的：为更安全的经口齿状突切除术提供必要的解剖学资料。寰椎的表面尺寸和经口入路的齿状突切除术已被详细描述。经口齿状突切除必须钻出C1前弓到达齿状突。C1前环厚度的研究尚未见报道。测量了60例成人寰椎、60例椎体和10例尸体颅颈标本的骨钻孔深度（BDD）， C1前环前壁到齿状突前壁的距离；(2)齿状突切除的最小钻孔直径（MDD）、C1前环最小切除距离；(3)最大骨钻孔直径（MBDD），齿状突切除最大C1前环的水平面距离。该直径的外侧边界受外侧肿块的内侧边界限制；(4)测量冠状面齿状体最宽直径（WOD）。60例寰椎和椎体干骨BDD为7.0 +/- 1.2 mm，侧块内侧边界（MBDD）距离为16.1 +/- 1.5 mm，冠状面WOD （WOD）距离为9.8 +/- 0.8 mm。在尸体上，C1前环切除用于齿状突切除（MDD）的边缘之间的距离为10.8 +/- 1.1 mm，冠状切面上的WOD （WOD）为10.1 +/- 1.4 mm。经口入路行齿状突手术是安全可行的。在考虑经口齿状突切除术时，定量了解C-1和C-2的前解剖是必要的。在这项研究中，作者定义了前寰椎和椎轴的安全区域。
An anatomical study for evaluation of anterior C1-C2. To provide essential anatomic data for safer transoral odontoidectomy. The surface dimensions of the atlas vertebra and the transoral approach for odontoidectomy have been described in detail. Anterior arcus of C1 must be drilled out to reach odontoid process for transoral odontoidectomy. The thickness of anterior ring of C1 has not been studied before. Sixty, dried adult atlas and 60 axis vertebrae and ten cadaveric craniocervical specimens were measured for the following: (1) bony drilling depth (BDD), the distance from the anterior wall of anterior ring of C1 to anterior wall of odontoid; (2) minimum drilling diameter (MDD), distance of minimum C1 anterior ring removal for odontoid resection on horizontal plane; (3) maximum bony drilling diameter (MBDD), distance of maximum C1 anterior ring removal for odontoid resection on horizontal plane. Lateral border of this diameter is limited by medial borders of the lateral mass; (4) the widest odontoid diameters (WOD) on coronal sections were measured. On 60 atlas and axis vertebrae, the BDD was 7.0 +/- 1.2 mm on dry bones, the distance between the medial borders of the lateral mass (MBDD) was 16.1 +/- 1.5 mm, and the WOD on coronal sections (WOD) was 9.8 +/- 0.8 mm. On cadavers, the distance between the two edges of C1 anterior ring removal for odontoid resection (MDD) was 10.8 +/- 1.1 mm and the WOD on coronal sections (WOD) was 10.1 +/- 1.4 mm. An odontoid surgery through transoral approach is safe and feasible. A quantitative understanding of the anterior anatomy of C-1 and C-2 is necessary when considering transoral odontoid resection. In this study the authors define safe zones for anterior atlas and axis.