目的 通过解剖学观察，揭示颈椎间孔内口区锚链韧带的形态及其分布特征，探讨其与神经根型颈椎病神经卡压之间的关系。 方法 12具成人脊柱颈段防腐标本，正中矢状切开，从脊神经根袖根部切断根袖，在外科显微镜下解剖观察C3/4～C7/T1椎间孔内口处神经根袖周围的锚链韧带，记录韧带的形态、分布、起止点及走行。 结果 120个椎间孔内口脊神经根袖周围共发现560条锚链韧带，所有韧带均呈放射状连于神经根袖与椎间孔内口周围骨膜壁，两端附着紧密，不易分离。各椎间孔内口韧带的数目均≥4个。锚链韧带形态主要包括带形和索形两种。带形韧带258条，宽度（4.5±2.6）mm（4.1~5.2 mm），索形韧带302条，直径（2.5±1.8）mm（1.2~3.8 mm）。C3/4、C7/T1椎间孔内口区韧带较为松散纤细，数量较少；C4/5~C6/7椎间孔内韧带较为坚韧而粗壮，数量较多。 结论 颈椎椎间孔内口区神经根周围存在锚链韧带，将神经根锚定于周围椎间孔骨膜壁，极大限制了神经根自由移动范围，可能与突出椎间盘一起导致神经根卡压，是神经根型颈椎病的潜在解剖学因素。
Abstract
Objective To reveal the shape and distribution characteristics of anchor chain ligament in intervertebral foramina and to explore the relationship between anchor chain ligament and nerve entrapment in cervical spondylotic radiculopathy. Methods Twelve adult specimens of cervical spine were dissected with electric saw in midsagittal incision. The root cuff was cut from the root of the nerve root cuff. The anchor-chain ligaments around the nerve root cuff at the internal orifice of the intervertebral foramen C3/4 to C7/T1 were dissected under a surgical microscope. The morphology, distribution, starting and ending points and course of ligaments were recorded. Results A total of 560 anchor chain ligaments were found around the nerve root sleeve of 120 interforaminal foramen. All ligaments were radially connected to the periosteum wall around the nerve root sleeve and the interforaminal foramen. The number of interforaminal orifice ligaments in each vertebra was more than 4. The morphology of anchor chain ligament mainly included two types: band shape and cable shape. There were 258 band ligaments with a width of (4.5±2.6) mm (4.1~5.2 mm), and 302 cord-shaped ligaments with a diameter of (2.5±1.8) mm (1.2~3.8) mm. The ligaments in the interforaminal orifice of C3/4 and C7/T1 were loose and thin, and the number of ligaments was less. C4/5~C6/7 interforaminal ligaments were tough and strong, and the number of ligaments was much more. Conclusions Anchor chain ligaments exist around nerve roots in the interforaminal orifice of cervical vertebra. Anchoring nerve roots to the periosteum wall of the interforaminal orifice greatly limits the free movement range of nerve roots, which may lead to nerve root compression together with disc herniation, which is a potential anatomical factor of radiculopathy.
关键词
颈椎间孔内口 /
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神经根型颈椎病 /
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锚链韧带 /
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临床解剖学
Key words
Entrance of intervertebral foramen /
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Radiculocervical spondylopathy /
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Anchor chain ligament /
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Clinical anatomy
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