椎管外臂丛神经根切断术的应用解剖

Applied anatomy of Amputation for Nerval Root of Brachial Plexus at External Vertebral Canal

目的:为椎管外臂丛神经根切断术提供解剖学资料。方法:在15具计30侧成人标本上解剖,观测了臂丛手术区的层次结构,臂丛神经根的毗邻关系。结果:臂丛神经根C_(5、6、7、8)、T_1依次高出锁骨上4.4±0.8cm、3.5±0.7cm、2.3±0.6cm、1.5±0.7cm和0.7±0.6cm。C-(5、6)合干部位多在前斜角肌外侧缘,C_7为单干,C_8、T_1合干被前斜角肌掩盖。皮肤至神经根深度分别为C_52.5±0.5cm、C_62.7±0.5cm、C_73.2±0.6cm、C_83.6±0.6cm和T_1 3.2±1.5cm。膈神经经前斜角肌表面外上斜向内下,C_8、T_1与胸膜顶关系密切。结论:椎管外单根神经根切断术,方法简便、安全、创伤小,具有可行性。

Objective:To provide anatomical basis for the amputation of nerval root of brachial plexus at external vertebral canal. Methods:The hierarchical structure in region of operation and the adjoining relation of nerval root of brachial plexus were anatomised and observed on 30 sides of adult cadavers. Results:The nerval root C5.6.7.8.T1 of brachial plexus overtop up clavicle 4.4 ± 0. 8cm,3. 5 ±0. 7cm,2.3 ± 0.6cm, 1. 5 ± 0. 7cm and 0.7 ± 0. 6cm. This nerval root assembles at lateral border of anterior scalene muscle. The 07 is single; the C8 and T1 together are coverdby anterior scalene muscle. The depth of the skin to the nerval root is C5 2.5±0.5cm;C6 2.7±0. 5cm;C7 3.2±0.6cm;C8 3.6±0.6cm;and T1 3.2± 1. 5cm. The phrenic nerve stride over the anterior scalene muscle on surface from the outside top to the inside bottom; the cupola of pleura is hand in glove withC8 and T1. Conclusion: The amputation of single nerval root at external vertebral canal has feasibility. It is simple,safe and leaves little wound.