枕下极外侧入路重要结构体表投影的解剖学量化研究

The quantitative anatomical study on body surface projection of the important structures for suboccipital extreme lateral approach

目的探讨和量化枕下极外侧入路重要结构的体表投影,为枕下极外侧入路手术提供数据支持。方法成年国人头颅干颅骨标本及寰椎、枢椎标本,以颧弓上缘为基线,经过乳突尖部的垂直基线的垂直线为参照线,游标卡尺测量各重要结构的体表投影数值。SPSS统计软件行统计学处理。在国人成人带颈头颅湿性标本上模拟的枕下极外侧入路中参考应用各项数据。结果寰椎横突在基线下距乳突尖垂直距离为(12.08±4.84)mm,寰椎横突在参照线前距乳突尖垂直距离为(8.24±1.61)mm。枢椎横突在基线下距乳突尖垂直距离为(11.39±2.27)mm,枢椎横突在参照线后距乳突尖垂直距离为(9.22±1.94)mm。枕大孔与寰椎间距为(7.33±2.22)mm,寰椎枢椎间距为(8.26±1.54)mm,寰椎横突结节宽度(5.97±1.23)mm,椎动脉沟近中线点距横突结节距离(28.94±3.77)mm。在模拟枕下极外侧入路过程中应用参照各项数据可以在硬膜外操作过程中安全地暴露游离椎动脉。结论枕下极外侧入路重要结构体表投影的量化研究结果为术者提供了可靠的数据支持与指导。

Objective To study quantitatively the body surface projection of the important structures for suboccipital extreme lateral approach to provide the anatomical data for clinic.Method 20 cases of cranial bones and lepospondylous and detata were utilized and the superior border of zygomatic arch was taken as baseline,the line through mastoidale vertically to the baseline was taken as reference line.The projection of important structures was measured by sliding caliper and the data were identified in operaton of suboccipital extreme lateral approach on two skull cadavers.Results The distance between transverse process of atlas and mastoidale is（12.08±4.84） mm beneath the base line and（8.24±1.61） mm ahead of the reference line.The distance between the transverse process of axis and transverse process of atlas is（11.39±2.27） mm under the baseline and（9.22±1.94） mm post of the reference line.The distance between foramen magnum and arch of posterior atlas is（7.33±2.22） mm,the distance between arch of posterior atlas and dentate is（8.26±1.54）mm,the distance between mastoidale and accessory nerve is（47.29±5.50） mm,the distance between groove for vertebral artery and nodus of transverse process is（28.94±3.77）mm.The above data were utilized successfully in the operation of suboccopital extreme lateral approach on two cadavers.Conclusion The quantitative anatomical studies on the projection of important structures for suboccopital extreme lateral approach could provide reliable data for clinic.