健侧C7神经移位经椎体前通路的解剖学研究及经颈椎后通路的解剖学探讨

发布时间：2018-01-19 13:33

  本文关键词： C7神经 神经移位 颈椎 解剖学　出处：《南华大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：通过建立椎体前通路，观察健侧C7神经能否显著缩短桥接神经长度并在此基础上实现与目标神经的直接吻合；同时探寻是否存在一条较椎体前通路相对简单安全且路径更短的通路。 方法：选取10具20侧正常成人尸体颈段标本，将双侧臂丛充分显露，远端向C7神经根前后股进行干支分离，在前后股加入外侧束及后束前将其切断，近端向椎间孔处游离，测量C7神经根从椎间孔至分股处的长度及C7神经至前后股长度，测量并记录C7神经根经椎体前通路、颈前皮下通路到对侧臂丛上、下干的距离；同时进一步解剖显露颈后部，观察颈后部的组织结构并探索建立颈椎后通路，同时通过此通路测量C7神经经颈椎后通道至对侧上下干的缺损距离。 结果：C7神经根的长度（58.62±8.70）mm；C7神经前、后股的长度分别为（70.03±10.79）mm，（65.15±9.11）mm；测量C7神经根经颈前皮下、椎体前通路、颈椎后通路至对侧上干的缺损长度分别是（98.18±10.18）mm，（32.10±11.49）mm，（43.22.±5.96） mm，且经椎体前通路至对侧上干所需桥接神经的长度明显短于经皮下通路、经颈椎后通路，且差异有统计学意义（P0.01）；C7神经根经颈前皮下、椎体前通路、颈椎后通路至对侧下干的缺损长度分别是（107.14±9.88）mm，（37.28±10.01）mm，（54.31±7.80）mm；且经椎体前通路至对侧下干所需桥接神经的长度明显短于经皮下通路、经颈椎后通路，差异有统计学意义（P0.01）；观察颈后部解剖特点，发现于颈后区建立通路周围无重要的血管及神经。 结论：较传统颈前皮下通路，健侧C7神经移位经椎体前通路能明显缩短桥接神经长度，有效利用了C7神经，，但未能减少神经吻合口，未能实现C7神经与目标神经的直接吻合；较椎体前通路，颈椎后通路降低了损伤血管神经的风险，较椎体前通路相对安全，但较其没有缩短C7神经与目标神经之间的距离。
[Abstract]:Objective: to establish whether the C7 nerve can significantly shorten the length of bridging nerve and achieve direct anastomosis with the target nerve based on the establishment of the anterior vertebral access. Meanwhile, we need to find out whether there is a relatively simple and safe path with a shorter path than the anterior vertebral artery.
Methods: 10 normal adult cadavers with 20 lateral cervical specimens, the bilateral brachial plexus were fully revealed, distal to the C7 nerve root before and after the separation of heavenly stems and Earthly Branches in stocks, stocks added before and after lateral beam and beam before it is cut off, the proximal free to the intervertebral foramen, measuring C7 nerve root from the intervertebral foramen to split. The length and C7 before and after femoral nerve to measure and record the length of the C7 nerve root by anterior pathway, anterior cervical subcutaneous pathway to the contralateral brachial plexus, under dry distance; and further anatomical structure observation revealed the back of the neck, the back of the neck and explore the establishment of cervical posterior pathway through this pathway and defect distance measurement C7 nerve to the contralateral posterior channel on stem.
缁撴灉锛欳7绁炵粡鏍圭殑闀垮害(58.62卤8.70)mm锛汣7绁炵粡鍓

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