根性撕脱的臂丛前根再植入脊髓的显微解剖

Microsurgical anatomy and approach of reimplanting avulsed brachial plexus ventral roots into the spinal cord

目的 探讨臂丛根性撕脱伤前根再植入脊髓的手术入路解剖。 方法 在 15例颈胸段尸体标本上 ,观测臂丛根及其前根解剖 ,测量椎动脉与颈椎、脊髓的关系 ,以及各脊髓节段与对应椎间盘的相对位置。另 4例标本采用侧前方入路行臂丛前根再植入术。 结果 由上至下臂丛根长度、脊髓节段长度、脊髓半径、前根根丝数及其起始处至中线距离逐渐减小 ,椎体半径、椎动脉至中线距离及前根长度逐渐增大 ;C5～ 7脊髓节对应C3～ 4、C4～ 5、C5～ 6椎间盘 ,C8、T1脊髓节对应C6、C7椎体。

Objective To study the approach of reimplanting avulsed brachial plexus ventral roots into the spinal cord Methods Fifteen cervicothoracic spine speciments were used to measure and observe the anatomy of brachial plexus roots and ventral roots, and the relationship of vertibral artery, vertebrae and spinal cord, and the relative position between spinal cord segment and vertebral discs Another four speciments were used to reimplant the brachial plexus ventral roots by the lateroventral approach Results From up to down, the length of brachial plexus roots and spinal cord segments, and the radius of spinal cord, and the number of ventral rootlets, and the distence from ventral root exit zones to midline became small, but the length of ventral roots, and the radius of vertebrae and the distence from vertebal artery to midline became big C 5～7 spinal cord segments faced C 3～4 ,C 4～5 ,C 5～6 vertebral discs, and C 8,T 1 spinal cord segments faced C 6,C 7 vertebrae Conclusions The brachial plexus ventral roots could be reimplanted into the best position by the lateroventral approach