| Objective: To observe and measure C1～3 for obtaining parameters of morphology in Chinese people via anatomy and imageology for designing neotype retropharyngeal cervical hook-plate(RCHP)which can be used to solve the reconstruction of C2 body and avoid some complications of the anterior atlanto-odontoid surgery. To evaluate preliminary clinical effect of RCHP in the reconstruction of C1-2 or C1-3.Method: This research was divided into two parts. In the first part, 40 sets of dry atlanto-axonal specimens and 50 Chinese adults'radiography on lateral neck vertebrae view were measured to obtain the relative anatomic parameters. The data were statistically analyzed in order to ascertain the morphological parameter range,based on which RCHP could be designed.In the second part, 6 patients with atlantoaxial disease underwent retropharyngeal surgery using RCHP. To record patiens'information about the surgery for summarizing the clinical application of RCHP and evaluate its initial clinical curative effect.Result: Measurement results showed that C1AW was for (20.06±1.16)mm,C1AH for (10.61±1.04)mm,C1AT for (4.09±0.66)mm,DW for (9.80±0.83)mm, DD for(10.13±0.63)mm, C2VAH for(22.03±1.99)mm, C2ATD for(16.80±1.26)mm, C2AP for(16.14±1.06)mm, AAOH for(37.44±3.2)mm, C2/3IDAH for(4.55±0.64)mm, C3BAH for(13.31±1.39)mm. The internal fixation device was composed of a couple of hook-plates and 2 or 4 affiliated screws.Surgical operation time was 90～150 minutes, (median 110 minutes). 5 patients were followed up from 0.5～10 months (median 3.58 months). All of them got primary healing. In the operation, no iniury was found on spinal cord , important nerves and blood vessel. 1 patient presented the symptom of superior laryngeal nerve injury after operation, such as drink-bucking, acataposis and so on, but he had improved in 1 week and recovered to normal eating in 2 months with treatments for nerves. 1 patient underwent lacerated wound of posteriorwall pharynx in operation. A??teriorwall pharynx sutura surgery was taken and the patient got pharynx intention in 1 week. 1 patient with anlanto-odontoid dislocation and posterior ligaments trauma of C1-2 presented anlanto-odontoid redislocation and neck pain after operation. He were managed with external orthoses and neck pain was dispeared in 2 months after sugery. Eventually bone graft had fused in 3 months postoperatively. The symptoms (e.g, neck pain) of other 4 patients had resolved in 1 week. 2 patients with type"O"anlanto-odontoid dislocation were found that the reposition of anlanto-odontoid was unsatisfactory on the postoperative radiographic evidence, other 2 cases with type"T2"anlanto-odontoid dislocation were satisfactory. 4 cases have shown bone graft fusion in 3～6 months, the anverage time was 4 weeks. (1 case is in 2 weeks after operation, so it isn't the time of bone graft fusion; 1 case refused treatments postoperatively because of relapse of tumor). No screws or hooks release was found at the time of the last follow-up.Conclusion: The designation of RCHP is feasible on morphology. Every part of the fixation device has their own parameter ranges. It can be installed successfully to excise and reconstruct C2 body by cervicum anterolateral retropharyngeal approach without complications of transoral-transpharyngeal approach. RCHP has some stability with simple structure, convenience operation and few complications.
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