颈椎前路扩大减压术的应用解剖

Applied anatomy of extensive decompression during anterior cervical approach

目的 :为颈椎前路扩大减压术提供应用解剖学基础。方法 :在 4 2具动脉灌注红色乳胶、防腐固定的成人尸体上 ,观察、测量双侧颈长肌内侧缘间距 (A)、横突孔前壁根部间距 (B)、椎动脉 V2段间距 (C)、颈长肌内侧缘与横突孔前壁根部间距 (D)、椎动脉与横突孔内壁间距 (E)、颈上神经节 (F)及颈中神经节 (G)距颈部中线的距离。结果 :A、B、 C由尾侧向头侧逐渐减小 ,F、G则逐渐增大 ;D约为 7.0 mm,E约为 3.0 m m。结论 :在颈椎前路扩大减压术中掌握横突孔前壁根部这一解剖标志可以避免损伤椎动脉和颈交感干。

Objective To provide the applied anatomical fundamental data for extensive decompression during anterior cervical approach. Methods Forty-two adult aseptic cadavers whose arteries were affused with red latex were used for observing. The distances of the medial border of bilateral Longus colli muscle (A), the roots of anterior wall of transversal foramen(B), V2 segments of vertebral artery (C), between the medial borders of Longus colli muscle and the root of anterior wall of transversal foramen(D), between V2 segment of vertebral artery and internal wall of transversal foramen(E), between the medial border of superior cervical ganglion(F), middle cervical ganglion(G) and midline were measured. Results The lengths of A,B, and C gradually decreased from caudal location to cephalad location, but the lengths of F and G gradually increased; D was about 7.0 mm and E was about 3.0 mm. Conclusion The sympathetic trunk and vertebral artery injuries can be completely avoided if the root of anterior wall of transversal foramen as anatomical signal in extensive decompression during anterior cervical approach is considered.