椎动脉V3段与第2颈神经毗邻关系的解剖学观测及其临床意义

doi:10.13418/j.issn.1001-165x.2025.1.02

中国临床解剖学杂志 ›› 2025, Vol. 43 ›› Issue (1): 9-13.doi: 10.13418/j.issn.1001-165x.2025.1.02

椎动脉V₃段与第2颈神经毗邻关系的解剖学观测及其临床意义

安雷雷¹，孔祥玉^{1, 2}*，刘鹏飞¹，张宾¹，马真¹，杜心如³*

1.新乡医学院三全学院人体解剖学教研室，河南新乡 453003； 2.承德医学院人体解剖学教研室，河北承德 067000； 3.首都医科大学附属北京朝阳医院，北京 100020

收稿日期:2024-04-28 出版日期:2025-01-25 发布日期:2025-01-22
通讯作者: 杜心如，教授，主任医师，E-mail：duxinru@163.com；孔祥玉，教授，E-mail：kongxiangyu58@163.com
作者简介:安雷雷（1989-），男，河南夏邑县人，讲师，医学硕士，研究方向：临床应用解剖学，E-mail：anleilei1003@126.com
基金资助:
新乡医学院三全学院骨干教师培养计划（SQ2025GGJS02）

Anatomical observation and clinical significance of the adjacent relationship between the V₃ segment and the second cervical nerve

An Leilei¹, Kong Xiangyu^1,2*, Liu Pengfei¹, Zhang Bin¹, Ma Zhen¹, Du Xinru³*

1. Department of Human Anatomy, Sanquan College of Xinxiang Medical University, Xinxiang 453003, Henan Province, China; 2. Department of Human Anatomy, Chengde Medical University, Chengde 067000, Hebei Province, China; 3. Department of Orthopedics, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China

Received:2024-04-28 Online:2025-01-25 Published:2025-01-22

摘要/Abstract

摘要： 目的观察椎动脉第3段垂直段（V3v）与第2颈神经（C2N）毗邻关系，为椎动脉型颈椎病(Cervical spondylotic arteriopathy, CSA)及枕颈痛合并眩晕的发生机制提供形态学依据。方法头颈标本33侧，解剖剥离法显露C2N和V3v及其相邻的结构，观测V3v与C2N交叉部位，范围及形态。结果所有标本中V3v与C2N前支均为横向交叉，跨越椎动脉后方（33/33，100%）。依据其接触程度可分为3种类型：①接触性交叉：C2N的前支依其条索状原形与V3v横向交叉，共6侧占18.2%；②压痕性交叉：C2N横跨V3v段呈扁带状或纵向凹痕状，共7侧占21.2%；③半缠绕压扁带性交叉：C2N前支呈扁带状横向半环形缠绕V3v，共20侧占60.6%。交叉处呈直角交叉16侧占48.5%。V3v交叉前和交叉处管径分别为（3.82±0.07） mm、（3.35±0.05） mm；交叉前和交叉处C2N前支宽径为（2.38±0.05） mm、（3.53±0.09） mm。交叉处距中线距离（23.25±0.39） mm；交叉处距同侧寰枢外侧关节囊距离（6.26±0.2） mm；距同侧C2-3关节突关节距离（11.78±0.3） mm。结论 V3v与C2N前支形成横向交叉性接触，其中以半缠绕压扁带性交叉为主，这种毗邻关系可能使C2N前支压迫V3v使大脑供血减少，可能是CSA发生机制之一和/或高血压合并枕颈痛的形态学基础。

关键词: 椎动脉第3段； , , 第2颈神经； , , 枕颈痛； , 椎动脉型颈椎病； , , 解剖剥离标本

Abstract: Objective To observe the adjacent relationship between V3v and C2N so as to provide morphological basis for the pathogenesis of cervical spondylotic arteriopathy (CSA) and both occipitocervical pain combined with vertigo. Methods Thirty-three sides of head-neck specimens were selected for this investigation. The anatomical dissecting and stripping methods were used to expose the C2N and V3v and the adjacent structure. The crossing part of C2N and V3v, range and morphology were observed. Results The anterior branch of C2N run laterally and crossed with V3v posteriorly in all specimen (33/33, 100%). According to the degree of contacts between C2N and V3v, these crossing relations could be divided into as three types: ① Simple contact crossing type: The original cord-shape anterior branch of C2N crossed with V3v laterally, with a total of 6 sides accounting for 18.2% ; ②Indentation crossing type: The segment of anterior branch of C2N which was crossing with V3v was in flat or longitudinal indentation shape, with a total of 7 sides accounting for 21.2%; ③Semi-circular wrapped crossing type: the anterior branch of C2N become flattened and wrapped the V3v in semi-circular way, with a total of 20 sides accounting for 60.6% . The anterior branches of C2N and V3v crossed each other in 16 sides at right angles, accounting for 48.5%. The diameters of V3v approaching to the crossing part and the crossing part were (3.82±0.07) mm and (3.35±0.05) mm, respectively. The width- diameter of the anterior branch of C2N approaching to the crossing part and the crossing part were (2.38±0.05) mm and (3.53±0.09) mm, respectively. The distances between intersection part and central line was (23.25±0.39) mm, the distance from crossing part to the ipsilateral lateral atlantoaxial joint was (6.26±0.2) mm, and the distance to the ipsilateral zygapophysial joint of C2 and C3 was (11.78±0.3) mm. Conclusions The anterior branch of the C2N formed three transverse crossing relationships with V3v, the dominant one among them is the semi-circular wrapped crossing type, this closing adjacent relations may lead the anterior branch of C2N to compresse V3v and may reduce the blood supply to the brain, it may be one of the pathogenesis of CSA and/or may be the morphological basis of hypertension with occipitocervical pain.

Key words: The V₃ segment of the vertebral artery; , , C₂ nerve; , , Occipitocervical pain; , , Vertebral artery type of cervical spondylosis; , , Dissected specimen by stripping

中图分类号:

R323.1

安雷雷, 孔祥玉, 刘鹏飞, 张宾, 马真, 杜心如. 椎动脉V₃段与第2颈神经毗邻关系的解剖学观测及其临床意义[J]. 中国临床解剖学杂志, 2025, 43(1): 9-13.

An Leilei, Kong Xiangyu, Liu Pengfei, Zhang Bin, Ma Zhen, Du Xinru. Anatomical observation and clinical significance of the adjacent relationship between the V₃ segment and the second cervical nerve [J]. Chinese Journal of Clinical Anatomy, 2025, 43(1): 9-13.

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椎动脉V₃段与第2颈神经毗邻关系的解剖学观测及其临床意义

Anatomical observation and clinical significance of the adjacent relationship between the V₃ segment and the second cervical nerve

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