中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (1): 17-20.

• 应用解剖 • 上一篇    下一篇

颈前外侧入路的应用解剖学研究

顾红林1, 张 烽1, 金国华2   

  1. 1.南通大学附属医院骨科; 2.南通大学医学院解剖学教研室,   江苏   南通    226001
  • 收稿日期:2010-05-04 出版日期:2011-01-25 发布日期:2011-01-24
  • 通讯作者: 张 烽,教授,主任医师,硕士生导师,博士, Tel:(0513)81161401,E-mail:zhf1017@hotmail.com E-mail:guhonglin_1983@126.com
  • 作者简介:顾红林(1983-),男,医学硕士,住院医师,研究方向:脊柱外科,现工作单位:盐城市第三人民医院,Tel:15061655886

The applied Anatomy research of Anterolateral approach to the cervical spine

GU Hong-lin1, ZHANG Feng1, JIN Guo-hua2   

  1. 1.Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, China; 2.Department of Anatomy, Medical School of Nantong University, Nantong 226001, China
  • Received:2010-05-04 Online:2011-01-25 Published:2011-01-24

摘要:

目的 为颈前外侧入路手术提供应用解剖学基础。  方法 对10具标本模拟右侧颈前外侧入路进行解剖观测。  结果 颈总动脉的分叉在C4水平为70%。面静脉70%在C3/4椎间盘水平注入颈内静脉。颈交感干位于椎前筋膜下方,行于颈动脉鞘的正后方,并在头长肌和颈长肌表面纵向延伸。C6水平颈交感干和颈长肌内侧缘之间的距离(14.5±4.8)mm, C6水平颈交感干的直径为(2.6±1.2)mm。上神经节位于C2水平,长度和宽度分别是(11.9±2.5) mm和(7.4±4.2)mm。中神经节位于C5水平4例,C6水平6例。长度和宽度分别是(8.9±5.9)mm和(5.1±3.2)mm,椎动脉无一例外都穿过C6横突孔上行。C5的钩突的高度和宽度是最小的,但是从钩突的内侧缘到横突的前结节却拥有最长的距离(P<0.05)。  结论 采用该入路对于颈椎前外侧的病理性损害具有直达病变部位、损伤小、减压彻底,最大程度上保留病变节段的运动性和脊柱的稳定性等优点。

关键词: 颈椎, 应用解剖, 前外侧入路, 颈椎病

Abstract:

Objective To provide basis of the applied anatomy basis for the anterolateral approach to cervical spine. Methods Ten cadavers were dissected, observed and measured through mimicing the right anterolateral approach to the cervical spine. Results The common carotid artery bifurcation was mostly found at the level of C4 (70%). The facial vein drained into the internal jugular vein mostly at the level of C3/4 (70%). Cervical sympathetic trunk was located posteromedial to carotid sheath and just anterior to the longus muscles. It extended longitudinally from the longus capitis to the longus colli over the muscles and under the prevertebral fascia. The average distance between the cervical sympathetic trunk and medial border of the longus colli muscle at C6 was (14.5±4.8) mm. The average diameter of the cervical sympathetic trunk at C6 was (2.6±1.2)mm. Superior ganglion of cervical sympathetic trunk in all dissections was located at the level of C2 vertebra. The length and width of the superior cervical ganglion were (11.9±2.5)mm and (7.4±4.2)mm, respectively. Forty percent of the middle ganglion was at the C5 level,  and 60%  was at C6 level, ; The the length and width of the middle cervical ganglion were (8.9±5.9)mm and( 5.1±3.2)mm. All of the vertebral artery arteries entered the transverse foramen of C6. The height and width of C5 uncinate process was were smallest but had the greatest distance from the medial edge of the uncinate process to the anterior tubercle (P<0.05). Conclusions Choosing anterolateral approach to the cervical spine approach could reach the lesion directly,causing less damage to the anterolateral transverse processes. This technique also allows through decompression, and preservation of cervical motion and spinal stability to the full extent.

Key words: Cervical spine, Applied anatomy, Anterolateral, Cervical spondylosis

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