Atlantoaxial lesions treated with internal fixation: Advantages of transoral approach

doi:10.3969/j.issn.2095-4344.2013.26.025

Abstract

Abstract:

BACKGROUND: Transoral approach is the traditional method for the treatment of atlantoaxial lesions, and is the hotspot and difficulty of the researches on spine surgery.
OBJECTIVE: To provide intuitive operation path for transoral approach reach to the craniocervical junction area, and to provide anatomical data for safe operation.
METHODS: Cadaver specimen received layer by layer surgical anatomy through transoral approach, and then the anatomical level, organization structure, and the relationship with the adjacent were observed. The main anatomical structures and the distances between structures were measured with the maker point of incisor; the distance between vertebral artery and center line and the atlantoaxial morphological structure were measured.
RESULTS AND CONCLUSION: Transoral anterior approach could directly expose the range from the middle-lower segment of the slope to the upper edge of C3 vertebral body, showed that the distance between bilateral vertebral arteries and center line was as follows: distance between left C1 vertebral artery and the center line was (20.72-29.70) mm, distance between right C1 vertebral artery and the center line was (20.36-28.98) mm, distance between left C2 vertebral artery and the center line was (13.10-23.00) mm, distance between right C2 vertebral artery and the center line was (13.85-24.02) mm. The distances from anterior tubercle, anterior odontoid process, posterior odontoid process, spinal dural, spinal cord, anterior C2 vertebral body and anterior C3 vertebral body to the incisor were (69.24-88.16) mm, (74.95-96.27) mm, (84.77-107.39) mm, (87.65-111.45) mm, (91.38-116.11) mm, (76.21- 92.77) mm and (78.53-105.13) respectively. The length of atlas was (19.8±2.3) mm, the height of odontoid process was (15.9±1.9) mm, the maximum transverse diameter was (10.5±0.6) mm, and the maximum sagittal diameter was (11.5±1.9) mm; the atlantoaxial maximum transverse diameter was (15.1±1.6) mm, the atlantoaxial maximum sagittal diameter was (17.7±1.3) mm, the distance from the outer edge of upper articular surface to the center line was (26.1±1.7) mm, and the distance between transverse foramen entrance and the upper articular surface was (8.1±1.3) mm. The anatomical structures of craniocervical junction are complex, and transoral approach has advantages in the treatment of craniocervical junction lesions within anatomical security range.

Key words: bone and joint implants, academic discussion of bone and joint, atlantoaxial, fixation, transoral approach, slope, odontoid process, vertebral artery, spinal cord, craniocervical junction, anatomy

CLC Number:

R318

Sun Ming-qi, Bao Guo-yu, Liu Bin. Atlantoaxial lesions treated with internal fixation: Advantages of transoral approach[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.26.025.

Figures/Tables 5

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