中国临床解剖学杂志 ›› 2014, Vol. 32 ›› Issue (5): 523-528.doi: 10.13418/j.issn.1001-165x.2014.05.005

• 应用解剖 • 上一篇    下一篇

颈椎前路减压手术解剖标志定位测量及其临床意义

林永绥1, 王万明2, 张发惠2, 郑和平2, 王春1   

  1. 1.福建医科大学附属闽东医院脊柱外科 宁德市骨科研究所,  福建   福安    355000;
    2.南京军区福州总医院军区骨科研究所,  福州   350025
  • 收稿日期:2014-05-31 出版日期:2014-09-25 发布日期:2014-10-14
  • 作者简介:林永绥(1976-),男,福建福鼎人,硕士,副主任医师,主要从事脊柱外科的基础与临床研究,Tel:(0593)6868508

Measurement and clinical significance on anatomic landmark of anterior cervical decompression

LIN Yong-sui1, WANG Wan-ming2, ZHANG Fa-hui2, ZHENG He-ping2,WANG Chun1   

  1. 1.Department of Spine Surgery, the Affiliated Mindong Hospital, Fujian Medical University, Fu’an 355000, China;  2.Orthopedics Institute, Fuzhou General Hospital, Nanjing Military District of Chinese PLA, Fuzhou 350025, China
  • Received:2014-05-31 Online:2014-09-25 Published:2014-10-14

摘要:

目的 为颈椎前路减压手术在有限显露术野中达到安全、有效减压提供更科学的减压标志。  方法 在15具成人尸体标本上,解剖观测C3~7节段相关解剖数据,以所测量的数据为基础,计算:(1)椎体钩前脚至颈长肌内侧缘的距离/颈长肌内侧缘至正中矢状面的距离(AULD/MLPD); (2)椎体钩前脚至横突孔内侧缘的距离/椎体钩前脚至颈长肌内侧缘的距离(AUTD/AULD); (3)椎体钩前脚至硬膜囊外侧缘的垂直距离/椎体钩后脚至硬膜囊外侧缘的距离(AUDD/PUDD)和(4)椎体钩与神经根最近点和椎体钩前脚的垂直距离/椎体钩前后脚的垂直距离(UNAD/APUD)。  结果 AULD/MLPD在C3的平均值为0.83,在C4的平均值为0.55,在C5的平均值为0.20,在C6的平均值为0.34,在C7的平均值为0.27;AUTD/AULD的平均值为2.71;AUDD/PUDD的平均值为0.28;UNAD/APUD的平均值为0.34。  结论 椎体钩前脚是颈椎体前部恒定的解剖标志,可作为颈椎前路手术的稳定、可靠的骨性减压标志,依据AUDD/PUDD、UNAD/APUD和AUTD/AULD的比值,有助于术中判断硬膜囊、颈神经根和椎动脉的位置。

关键词: 前路减压手术, 解剖标志, 解剖学研究, 颈椎

Abstract:

Objective The primary purpose of the current study is to provide more scientific landmarks for safe and efficient decompression within limited operating field in cervical anterior decompression. Methods Relative data were observed and measured at C3~7 of 15 adult cadaveric specimens and some data were calculated basing on above data: the ratio of anterior crus of uncinate process-medial border of longus colli muscle distance and medial border of longus colli muscle-median sagittal plane distance(AULD/MLPD), the ratio of anterior crus of uncinate process-medial border of foramen transversarium distance and anterior crus of uncinate process-medial border of longus colli muscle distance(AUTD/AULD), the ratio of anterior crus of uncinate process-lateral border of dural sac perpendicular distance and posterior crus of uncinate process-lateral border of dural sac distance(AUDD/PUDD), and the ratio of the nearest point of uncinate process and nerve root-anterior crus of uncinate process perpendicular distance and anteroposterior crus of uncinate process perpendicular distance(UNAD/APUD).  Results AULD/MLPD averaged 0.83 at C3, 0.55 at C4, 0.20 at C5, 0.34 at C6, and 0.27 at C7. AUTD/AULD averaged 2.71, AUDD/PUDD averaged 0.28, and UNAD/APUD averaged 0.34. Conclusion Anterior crus of uncinate process is a consistent anatomic landmark at anterior border of cervical vertebrae, which could serve as a stationary and reliable landmark in cervical anterior decompression, and facilitate the location of dural sac, cervical nerve root and vertebral artery during operation according to the ratios of AUDD/PUDD, UNAD/APUD and AUTD/AULD.

Key words: Anterior decompression, Anatomic landmark, Anatomic study, Cervical vertebrae

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