椎动脉高跨和颈2椎板螺钉.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,椎动脉高跨和颈,2,椎板螺钉,（,High-Riding Vertebral Artery/C2 laminar screws,）,俞武良,2018-3-21,C,2,pedicle screw,vertebral artery(VA),VA injury,4.1%to 8.2%for posterior atlantoaxial transarticular screw fixation,5.3%21%,for C2 pedicular screw,Factors contribute to VA injury,VA groove(VAG)anomaly,high-riding vertebral artery,14.5%18%,narrow C2 pedicle,9.5%32%,insertion of the screw extremely close to the VA,HRVA,defined as having an isthmus height of 5 mm and/or an internal height of 2 mm on the sagittal image 23 mm lateral to the cortical border of the spinal canal at C2.,narrow C2 pedicle,defined as having the largest pedicular width of 4 mm on the axial image,high-riding vertebral artery(HRVA),椎动脉在枢椎上关节突的下方有一个向外的弯曲,如果椎动脉弯曲过于向后、内或位置过高,则提示枢椎峡部狭窄,这种情况称为椎动脉高跨,C2 laminar screw(Wright 2004),我们最近的病例,。