后路

Objective: To clarify the technical parameters in posterior atlanto-occipital transarticular screw fixation and discuss the clinical significance of occipitocervical junction fixation with transarticular screws.

目的：明确后路寰枕关节经关节螺钉固定的技术参数；探讨枕颈部经关节螺钉内固定技术的临床意义。

Direction and length of trajectory are the key of posterior atlano-occipital transarticular fixation, if combined with C1-C2 transarticular fixation, it will be an ideal fixation method for occipitocervical fusion.

寰枕关节后路经关节螺钉植入存在一定的方向性和钉道长度，结合后路C1-C2经关节螺钉内固定后可视为能满足当前临床需要的一种相对理想的枕颈融合内固定术式。

Clinical results showed that posterior screw fixation on atlas could relieve spinal and neural oppression immediately,improve clinical symptoms,have good immediate postoperative stability,keep the movement of occipitocervical region,and showed its advantages in very high successful fusion rate,and very few instrument failure,morbidity and complications.

临床结果显示：后路寰椎螺钉固定技术能即刻解除脊髓神经压迫、缓解症状，有较好的即刻稳定性，保留枕颈间的运动功能，并且有融合率极高，断钉率、疾病复发以及术后并发症极少等优越性。

Objective. To stress the importance of the fusion angle of the occipitocervical spine based on an unusual case of upper-airway obstruction after a posterior fusion from the occipital bone to the second cervical vertebra (O-C2) in a flexed position.

目标：通过一例少见的后路枕骨与颈2在屈曲位融合术后出现上气道梗阻的病例强调枕颈脊柱融合角度的重要性。

The exclusion of pathoanatomical data from the Nationwide Inpatient Sample database, of key importance in guiding the surgical approach, prevents any conclusions being drawn about the merits and disadvantages of anterior versus posterior surgery.

若从全国住院患者样本数据库中删除对指导手术入路有重要意义的病理解剖学数据，则无法通过对比而得出任何关于前后路手术的优势和不足的结论信息。

A high failure rate of stand-alone, short-segment pedicular fixation in the setting of thoracolumbar burst fractures prompted the development of the load-sharing classification system of thoracolumbar fractures, which allowed guidance in understanding the potential for failure of posterior instrumentation alone in the setting of significant disruption of the anterior vertebral body.

在胸腰椎爆裂骨折中，单独使用短节段椎弓根内固定，有较高的失败率，从而促进了Load－sharing分类的发展。Load－sharing分类为我们理解在前柱严重碎裂的情况下单独使用后路内固定器械而潜伏的内固定失败，提供了指导依据。

In Perciformes, chromaffin cells are distributed around the anterior and posterior cardinal veins and ducts of Cuvier; in Salmoniformes, around the posterior cardinal veins and in the hematopoietic tissue; and in G. affinis, around the ducts of Cuvier and posterior cardinal veins, while a few are visible also around the sinus venosus.

在鲈、铬细胞周围分布前后主教Cuvier脉及管道；在鲑鳟鱼类、周围静脉和后部主教在造血组织； G、慈、氩在地层的管道打通Cuvier后路主教，同时也有不少是围绕着静脉窦。

Methods Fourteen adult cadaver specimens of cervical spine（C3～C7）with intact structures including ligaments and perivertebral muscles were reserved and used.

随机取14具福尔马林浸泡的成人颈椎标本（C3～C7），保留完整的脊柱三柱结构及相关的韧带和椎旁肌，根据影像学测量的进钉点和进钉方向，模拟颈椎后路手术过程。

Abstract］ Objective To explore the accuracy and safety of safety drillprepared for cervical pedicle screw trajectory.Methods Fourteen adult cadaver specimens of cervical spine（C3～C7）with intact structures including ligaments and perivertebral muscles were reserved and used.

目的 探索安全钻头应用于颈椎弓根螺钉孔道钻探的安全性与准确性方法随机取14具福尔马林浸泡的成人颈椎标本（C3～C7），保留完整的脊柱三柱结构及相关的韧带和椎旁肌，根据影像学测量的进钉点和进钉方向，模拟颈椎后路手术过程。

Abstract］ objective to explore the accuracy and safety of safety drillprepared for cervical pedicle screw trajectory.methods fourteen adult cadaver specimens of cervical spine（c3～c7）with intact structures including ligaments and perivertebral muscles were reserved and used.according to the radiographic measurements,safety drill was inserted into cervical pedicle individually.the evaluation of the drill's trajectory was carried out by ct scan and three-dimension reconstruction and autopsy.results one hundred and forty drill's trajectories were made.9 holes failed with a perforation rate of 6.4%.conclusion the safety drill prepared for cervical pedicle screw hole is safe and effective and can be applied and popularized clinically.

目的 探索安全钻头应用于颈椎弓根螺钉孔道钻探的安全性与准确性。方法随机取14具福尔马林浸泡的成人颈椎标本（c3～c7），保留完整的脊柱三柱结构及相关的韧带和椎旁肌，根据影像学测量的进钉点和进钉方向，模拟颈椎后路手术过程。选用安全钻头，进行实际的颈椎弓根螺钉孔道的钻探，将孔道行ct扫描，并斜位三维重建孔道形态，并以肉眼直视观察结果为金标准，评价孔道钻探的成败。结果钻探孔道准确率89.3%（125/140），穿孔率6.4%（9/140）。结论安全钻头应用于颈椎弓根螺钉孔道钻探的安全性与准确性均较高，可以在临床上推广使用。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。