在患有和没有基底性阴道感染的患者之间,用于跨脚架螺丝安置的C1后变化的特征和评估
Lu-Ping Zhou1,2, Chen-Hao Zhao1,2, Zhi-Gang Zhang1,2
1Department of Orthopedics and Spine Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China.
概括
C1跨脚螺丝 (C1TS) 的放置在基底内 (BI) 中具有挑战性,原因是大气 Atlas 异常. 这项研究对后侧形变异进行了分类,并确定了BI患者的最佳C1TS轨迹,推先进的成像以确保安全的螺丝放置.
科学领域:
- 神经外科和骨架脊椎外科手术
- 解剖学变化和手术规划
- 脊柱植入物的生物力学分析
背景情况:
- C1跨脚螺丝 (C1TS) 放置提供了稳定性,但面临的挑战在基底内膜异位 (BI) 患者由于大气 Atlas 异常和脊椎动脉 (VA) 变化.
- 现有的文献缺乏C1后变异的详细分类及其对BI中的C1TS插入轨迹的具体影响.
- 了解这些变异对于优化C1TS安置和确保BI病例患者安全至关重要.
研究的目的:
- 在有或没有BI的患者中调查大西洋骨和周围动脉的特征.
- 为了分类C1后变异,并确定它们对C1TS的指示.
- 为了评估和比较理想的C1TS插入轨迹在BI患者与没有亚特拉斯头化 (AO) 的对照.
主要方法:
- 一项比较研究包括来自两个医疗中心的130名非AO患者 (52名BI,78名对照).
- 使用修改后的形态系统对C1后变异进行了分类.
- 骨和动脉特征,形态分布和理想的C1TS轨迹在使用统计分析的组之间进行了比较,包括多重线性回归.
主要成果:
- 与对照组相比,BI患者的亚特拉斯尺寸显著减少,VA和VA槽 (VAG) 之间的距离减少.
- 四种后变异类型被分类,I型和II型适合C1TS;BI患者的I型发病率较低.
- 插入参数,包括角度和距离,在BI和对照组之间以及在形态亚型之间有显著差异,BI患者表现出更窄的轨迹和更多的横向角度.
结论:
- 后变异在BI患者中更为常见,影响C1TS插入参数,并且由于VA附近的解剖空间较小,增加了风险.
- 特定的形态分类指导C1TS适用性和BI中的轨迹调整.
- 在BI患者中,强烈建议进行手术前的3DCT,CT血管造影和手术内导航,以确保安全的C1TS安置.
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