课题背景：怎样保证在寰枢椎稳定的前提下，保留寰枢椎的旋转功能，既可达到牢固的固定,同时又可最大限度地保留脊柱的运动功能,这将是未来脊柱内固定的发展趋势。系列研究包括：①干燥寰枢椎骨骼标本测量，取得相关解剖数据。②根据解剖测量数据，设计、制造人工寰椎齿状突关节。③对新鲜尸体头颈部标本进行咽后壁显微外科解剖，并模拟经口咽入路手术，切除寰椎前弓和齿状突，安置人工寰椎齿状突关节，证实人工寰椎齿状突关节的可操作性。④对安装人工寰椎齿状突关节的颈椎标本进行生物力学测试，包括：弹性实验、刚度测试和疲劳实验。⑤对人工寰椎齿状突关节进行有限元分析。

应用要点：对干燥寰枢椎骨骼标本测量，取得相关解剖数据，设计、制造人工寰椎齿状突关节，是人工寰椎齿状突关节系列研究的第一步，后续的实验重点研究人工寰椎齿状突关节的可行性、稳定性、旋转功能、抗疲劳性以及生物相容性等性能特点，为进入临床实验阶段提供依据。

偏倚或不足：人工寰椎齿状突关节尚需要进一步研究和改进才能满足临床需求，比如在寰椎固定板与寰椎侧块的接触面以及枢椎底座1、固定板与枢椎椎体接触面设计成成骨细胞容易附着、骨小梁容易长入的涂层，又比如在旋转轴套与旋转轴、底座2之间加入超高分子量材料或其他材料，进一步降低人工寰椎齿状突关节的磨损。

摘要
目的：对正常成年干燥寰枢椎标本进行解剖学测量，为设计、制造寰椎齿状突人工关节提供依据。
方法：实验于2006-09/2007-12在西安交通大学医学院人体解剖实验室完成。50 套正常成年人干燥寰枢椎标本，均由西安交通大学解剖教研室提供，经大体观察证实无骨性异常。采用电子游标卡尺( 精确度0.01 mm) 和附着式量角器( 精确度0.1°) 测量寰枢椎标本的各项参数。根据解剖测量结果设计、制造寰椎齿状突人工关节。
结果：测得寰椎前弓高度（11.1±1.3）mm，寰椎前弓宽度（16.6±1.7） mm，寰椎侧块中部长度（17.8 ±1.7） mm，寰椎侧块中部宽度（14.1±1.5） mm，寰椎侧块中部高度（13.5±1.6） mm，枢椎齿状突高度（15.7±1.1） mm，枢椎齿状突前后径（10.9±0.8） mm，枢椎齿状突横径（9.3±0.7） mm，枢椎椎体长度（17.4±1.7） mm，枢椎椎体宽度（18.2±1.8） mm，枢椎椎体高度（21.1±1.8） mm，寰椎侧块外倾角（11.3±4.2）°，枢椎齿状突后倾角（9.8±2.1）°等解剖测量数据，仿生设计、制造出钛合金寰椎齿状突人工关节。
结论：根据寰枢椎标本解剖学测量数据，在形态学和动力学两方面进行仿生，设计、制造出人工寰椎齿状突关节，符合目前从单纯脊柱融合到综合考虑脊柱稳定和功能的脊柱外科研究发展趋势。
关键词：颈椎经口咽入路；人工寰椎齿状突关节；解剖学；寰椎；枢椎

陆斌，李广琪，李建武，李乐涛，谢延，白国玺.依据寰枢椎解剖学测量设计制造寰椎齿状突人工关节[J].中国组织工程研究与临床康复，2008，12(17):3237-3240 [www.zglckf.com/zglckf/ejournal/upfiles/08-17/17k-3237(ps).pdf]

Atlantoaxial anatomy measurement-based design of atlas odontoid process artificial joint

Abstract

AIM:To anatomically measure atlantoaxial dry specimens of normal adults to provide references for the design and manufacture of transoral approach atlas odontoid process artificial joint.
METHODS: The experiment was performed at Human Anatomy Laboratory of Medical College of Xi’an Jiaotong University from September 2006 to December 2007. Fifty sets of normal adult atlantoaxial dry specimens were provided by Department of Anatomy, Xi’an Jiaotong University, which was identified with no bony abnormity by gross observation. The specimens were measured using electronic vernier caliper (accuracy degree, 0.01 mm) and protractor (accuracy degree, 0.1°). Atlas odontoid artificial joints were designed and produced according to anatomical measurements.
RESULTS: Atlas anterior arch height and width were (11.1±1.3) mm and (16.6±1.7) mm, respectively; atlas lateral mass length, width and height were (17.8±1.7) mm, (14.1±1.5) mm, and (13.5±1.6) mm; Axis odontoid process height was (15.7±1.1) mm; Odontoid sagittal diameter was (10.9±0.8) mm; Odontoid transverse diameter was (9.3±0.7) mm; Axis body length, width, and height were (17.4±1.7) mm, (18.2±1.8) mm, and (21.1±1.8) mm; Atlas lateral mass lateral tilt angle was (11.3 ± 4.2)°, and Atlas lateral mass retroversion angle was (9.8 ± 2.1)°. According to these measurement data of atlantoaxial anatomy, titanium alloy atlas odontoid artificial joints were designed and manufactured.
CONCLUSION: According to anatomical measurements of atlantoaxial dry specimens, we design and manufacture titanium alloy atlas odontoid artificial joints from morphology and kinetics. This method is accorded with the developing trend of spinal surgery research from simple spinal fusion to spinal stability and function.

Lu B, Li GQ, Li JW, Li LT, Xie Y, Bai GX.Atlantoaxial anatomy measurement-based design of atlas odontoid process artificial joint. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(17):3237-3240(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-17/17k-3237(ps).pdf]