福建闽西地区颈寰椎同侧弓状孔和椎动脉高跨的发生率及其临床意义

Incidence Rate of Ipsilateral Arcuate Foramen of Atlas and Vertebral Artery High Span and Clinical Significance in West Fujian Region

目的研究闽西地区颈寰椎弓状孔和椎动脉高跨这种解剖结构变异的发生率。方法方便选取福建省龙岩市第一医院2005年1月—2016年12月年收治的98例颈椎病患者,使用薄层CT扫描及二维重建来判断寰椎的变异情况。其中包括判定寰椎弓状孔的位置:左侧、右侧或是双侧出现,同时测量枢椎侧块峡部的厚度以及高度。当峡部厚度<5 mm或是高度<2 mm时,称之为椎动脉高跨。结果 98例患者中,15例患者具有完全成形的弧形孔。其中,7例患者为左侧,3例为右侧,5例为双侧出现。此外,有23例患者形成寰椎弓状孔未闭。32例患者被确定为椎动脉高跨。其中,有13例为左侧,9例为右侧,10例为双侧。他们之中有5例患者出现一侧同时发生寰椎弓状孔及椎动脉高跨。结论寰椎弓状孔和椎动脉高跨这种解剖结构的变异普遍存在于闽西地区,但往往容易被忽略。尽管同侧同时出现寰椎弓状孔和椎动脉高跨的变异非常罕见,但术前CT辅助诊断能够减少寰枢椎内固定术中椎动脉的损伤发生率。

Objective To research the incidence rate of anatomic structure variation of ipsilateral arcuate foramen of atlas and vertebral artery high span. Methods 98 cases of patients with cervical spondylosis admitted and treated in our hospital from January 2005 to December 2016 were convenient selected and the variation of atlas was determined by the thin slice CT scan and two dimensional reconstruction, including the determination of atlas ipsilateral arcuate foramen size and measurement of thickness and height, when the isthmus thickness 〈5 mm or height 〈2 mm, we referred it as the vertebral artery high span. Results Of 98 cases of patients, 15 cases were with fully formed camber hole, including 7 cases in left site, 3 cases in right site and 5 cases in bilateral site, besides, there were 23 cases with unclosed ipsilateral arcuate foramen, 32 cases were with vertebral artery high span, including 13 cases in left site, 9 cases in right site and 10 cases in bilateral site, and 5 cases were with ipsilateral arcuate foramen of atlas and vertebral artery high span. Conclusion The variation of this anatomy structure of ipsilateral arcuate foramen of atlas and vertebral artery high span is commonly in west Fujian region, but it is usually ignored, and the variation of ipsilateral arcuate foramen of atlas and vertebral artery high span in the same site is very rare, but the preoperative CT adjunctive diagnosis can reduce the incidence rate of vertebral artery injuries in the atlantoaxial internal fixation.