颈前外侧入路的应用解剖学研究

顾红林, 张 烽, 金国华

中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (1) : 17-20.

中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (1) : 17-20.
应用解剖

颈前外侧入路的应用解剖学研究

  • 顾红林1, 张 烽1, 金国华2
作者信息 +

The applied Anatomy research of Anterolateral approach to the cervical spine

  • GU Hong-lin1, ZHANG Feng1, JIN Guo-hua2
Author information +
文章历史 +

摘要

目的 为颈前外侧入路手术提供应用解剖学基础。  方法 对10具标本模拟右侧颈前外侧入路进行解剖观测。  结果 颈总动脉的分叉在C4水平为70%。面静脉70%在C3/4椎间盘水平注入颈内静脉。颈交感干位于椎前筋膜下方,行于颈动脉鞘的正后方,并在头长肌和颈长肌表面纵向延伸。C6水平颈交感干和颈长肌内侧缘之间的距离(14.5±4.8)mm, C6水平颈交感干的直径为(2.6±1.2)mm。上神经节位于C2水平,长度和宽度分别是(11.9±2.5) mm和(7.4±4.2)mm。中神经节位于C5水平4例,C6水平6例。长度和宽度分别是(8.9±5.9)mm和(5.1±3.2)mm,椎动脉无一例外都穿过C6横突孔上行。C5的钩突的高度和宽度是最小的,但是从钩突的内侧缘到横突的前结节却拥有最长的距离(P<0.05)。  结论 采用该入路对于颈椎前外侧的病理性损害具有直达病变部位、损伤小、减压彻底,最大程度上保留病变节段的运动性和脊柱的稳定性等优点。

Abstract

Objective To provide basis of the applied anatomy basis for the anterolateral approach to cervical spine. Methods Ten cadavers were dissected, observed and measured through mimicing the right anterolateral approach to the cervical spine. Results The common carotid artery bifurcation was mostly found at the level of C4 (70%). The facial vein drained into the internal jugular vein mostly at the level of C3/4 (70%). Cervical sympathetic trunk was located posteromedial to carotid sheath and just anterior to the longus muscles. It extended longitudinally from the longus capitis to the longus colli over the muscles and under the prevertebral fascia. The average distance between the cervical sympathetic trunk and medial border of the longus colli muscle at C6 was (14.5±4.8) mm. The average diameter of the cervical sympathetic trunk at C6 was (2.6±1.2)mm. Superior ganglion of cervical sympathetic trunk in all dissections was located at the level of C2 vertebra. The length and width of the superior cervical ganglion were (11.9±2.5)mm and (7.4±4.2)mm, respectively. Forty percent of the middle ganglion was at the C5 level,  and 60%  was at C6 level, ; The the length and width of the middle cervical ganglion were (8.9±5.9)mm and( 5.1±3.2)mm. All of the vertebral artery arteries entered the transverse foramen of C6. The height and width of C5 uncinate process was were smallest but had the greatest distance from the medial edge of the uncinate process to the anterior tubercle (P<0.05). Conclusions Choosing anterolateral approach to the cervical spine approach could reach the lesion directly,causing less damage to the anterolateral transverse processes. This technique also allows through decompression, and preservation of cervical motion and spinal stability to the full extent.

关键词

颈椎 / 应用解剖 / 前外侧入路 / 颈椎病

Key words

Cervical spine / Applied anatomy / Anterolateral / Cervical spondylosis

引用本文

导出引用
顾红林, 张 烽, 金国华. 颈前外侧入路的应用解剖学研究[J]. 中国临床解剖学杂志. 2011, 29(1): 17-20
GU Hong-Lin, ZHANG  Feng, JIN Guo-Hua. The applied Anatomy research of Anterolateral approach to the cervical spine[J]. Chinese Journal of Clinical Anatomy. 2011, 29(1): 17-20
中图分类号: R323.1   

参考文献


[1]  孙 俊, 钟世镇. 上部颈椎经颈前外侧手术入路的应用解剖
[J]. 中国临床解剖学杂志, 1998, 16 (1):45-48.

[2] Verbiest H. A lateral approach to the cervical spine: technique and indications
[J]. J Neurosurg, 1968, 28(3):191-203.

[3]巨辉, 程智, 吴云松. CT引导下经颈前外侧入路穿刺行颈椎椎间盘突出胶原酶溶解术临床研究
[J]. 中外医疗, 2008, (15):69-70.

[4]菅凤增, 陈赞, 苏春海, 等. 颈椎前外侧入路椎间孔扩大术治疗神经根型和椎动脉型颈椎病的初步临床报告
[J]. 中国现代神经疾病杂志, 2009, 9 (2):130-134.

[5]  Yasuda M, Bresson D, Cornelius JF, et al. Anterolateral approach without fixation for resection of an intradural schwannoma of the cervical spinal canal: technical note
[J]. Neurosurgery, 2009, 65(6):1178-1181

[6]  Civelek E, Kiris T, Hepgul K, et al. Anterolateral approach to the cervical spine: major anatomical structures and landmarks. Technical note
[J]. J Neurosurg Spine, 2007, 7(6):669-678.

[7] Saylam CY, Ozgiray E, Orhan M, et al. Neuroanatomy of cervical sympathetic trunk: a cadaveric study
[J]. Clin Anat, 2009, 22(3):324-330.

[8]  Lyons AJ, Mills CC. Anatomical variants of the cervical sympathetic chain to be considered during neck dissection
[J]. Br J Oral Maxillofac Surg, 1998, 36(3):180-182.

[9]  Bruneau M, Cornelius JF, George B. Anterolateral approach to the V2 segment of the vertebral artery
[J]. Neurosurgery, 2005, 57(4 Suppl):262-267.

[10]包聚良. 下颈椎的侧方外科入路解剖及其临床意义
[J]. 中国临床解剖学杂志, 1998, 16(4):339-340.


Accesses

Citation

Detail

段落导航
相关文章

/