RESUMO
OBJECTIVE: Minimally invasive atlantoaxial surgery offers the benefits of reduced trauma and quicker recovery. Previous studies have focused on feasibility and technical aspects, but the lack of comprehensive safety information has limited its availability and widespread use. This study proposes to define the feasibility and range of surgical safety using the intersection of the greater occipital nerve and the inferior border of the inferior cephalic oblique as a reference point. METHODS: Dissection was performed on 10 fresh cadavers to define the anatomical reference point as the intersection of the greater occipital nerve and the inferior border of the inferior cephalic oblique muscle. The study aimed to analyze the safety range of minimally invasive atlantoaxial fusion surgery by measuring the distance between the anatomical reference point and the transverse foramen of the axis, the distance between the anatomical reference point and the superior border of the posterior arch of the atlas, and the distance between the anatomical reference point and the spinal canal. Measurements were compared using Student's t test. RESULTS: The point where the occipital greater nerve intersects with the inferior border of the inferior cephalic oblique muscle was defined as the anatomical marker for minimally invasive posterior atlantoaxial surgery. The distance between this anatomical marker and the transverse foramen of the axis was measured to be 9.32 ± 2.04 mm. Additionally, the distance to the superior border of the posterior arch of the atlas was found to be 21.29 ± 1.93 mm, and the distance to the spinal canal was measured to be 11.53 ± 2.18 mm. These measurement results can aid surgeons in protecting the vertebral artery and dura mater during minimally invasive posterior atlantoaxial surgery. CONCLUSIONS: The intersection of the greater occipital nerve with the inferior border of the inferior cephalic oblique muscle is a safe and reliable anatomical landmark in minimally invasive posterior atlantoaxial surgery.
Assuntos
Vértebras Cervicais , Procedimentos Cirúrgicos Minimamente Invasivos , Humanos , Vértebras Cervicais/cirurgia , Artéria Vertebral , CadáverRESUMO
The melt-blowing process involves high velocity airflow and fiber motion, which have a significant effect on fiber attenuation. In this paper, the three-dimensional airflow field for a melt-blowing slot die was measured using the hot-wire anemometry in an experiment. The fiber motion was captured online using a high-speed camera. The characteristics of the airflow distribution and fiber motion were analyzed. The results show that the melt-blowing airflow field is asymmetrically distributed. The centerline air velocity is higher than that around it and decays quickly. The maximum airflow velocity exists near the die face, in the range of 130-160 m/s. In the region of -0.3 cm < y < 0.3 cm and 0 < z < 2 cm, the airflow has a high velocity (>100 m/s). As the distance of z reaches 5 cm and 7 cm, the maximum airflow velocity reduces to 70 m/s. The amplitude of fibers is calculated, and it increases with the increase in air dispersion area which has a significant influence on fiber attenuation. At z = 1.5 cm, 2.5 cm, 4 cm, and 5.5 cm, the average fiber amplitudes are 1.05 mm, 1.71 mm, 2.83 mm, and 3.97 mm, respectively. In the vicinity of the die, the fibers move vertically downward as straight segments. With the increase in distance from the spinneret, the fiber appears to bend significantly and forms a fiber loop. The fiber loop morphology affects the velocity of the fiber movement, causing crossover, folding, and bonding of the moving fiber. The study investigated the interaction between the fiber and airflow fields. It indicates that the airflow velocity, velocity difference, and dispersion area can affect the motion of fiber which plays an important role in fiber attenuation during the melt-blowing process.