ลักษณะโครงสร้างส่วนลามิน่าของกระดูกคอปล้องที่สองต่อความปลอดภัย ในการใส่สกรูยึดตรึงกระดูกส่วนลามิน่าในกลุ่มประชากรไทย

บทคัดย่อ

Atlantoaxial fixation is indicated for C1-2 segmental instability. Recently, translaminar
screw fixation offers an provides technique with more Safety for cervical operation Accosting
to the information of the lamina size, its trajectory in Thai population is crucial for safe and
effective fixation. To evaluate lamina morphology of axis in Thai population by C2 lamina
measure most of was performed on CT images in 60 human adults (male 35, female 25).
The outer narrowest of axial diameter, the outer narrowest of sagittal diameter, spino-lamina
angle, lamina length and minimal spinous process height were measured bilaterally using PACs
System. The results were found that the mean outer narrowest of axial diameter was 3.42±0.35
mm in male and 3.39±0.32 mm in female. The mean outer narrowest sagittal diameter was
9.1±0.33 mm in male and 9.0±0.31 mm in female. The mean height of C2 spinous process was
9.82±0.33 mm in male and 9.78±0.32 mm in female. The mean length of lamina was 32.9±1.45
mm in male and 32.7±1.43 mm in female. The spino-lamina angle was 45.8°±3° in male and
46.4°±4° in female. This study can be concluded that translaminar screws fixation using screw
diameter and length not more than 3 and 30 mm respectively should be cautioned in Thai
population. The screws can be inserted without breaking into spinal canal if the entry angle
> 43°. All patients could be inserted bilateral translaminar screw fixation. Precious computerized
tomographic imaging was used as an important indicators for to pre-operative planning.