臂丛神经根椎管内解剖学观测

发布时间：2019-02-08 21:13

【摘要】： [目的]观测椎管内臂丛神经前后根的形态及特点，并阐明臂丛神经前后根与椎间孔的空间毗邻关系及其意义，为臂丛根性撕脱伤及神经根型颈椎病的诊治和前者修复手术的改进提供解剖学基础。 [方法]取正常人体脊柱防腐标本15个。打开颈椎管，显露双侧臂丛神经，测量椎间孔内外口平面臂丛神经的断面面积、椎间孔外口平面面积和椎间孔上下径、前后径；测量椎管内C_5-T_1神经前后根各级分支数目及其长度；并且测量C_5-T_1神经前根与脊髓纵轴的夹角；前后根起始处距脊髓前后正中沟的距离。 [结果]椎间孔内、外口处臂丛神经断面面积测量显示：C_5到C_8逐渐增加，T_1神经根最细。而椎间孔内(外)口处臂丛神经断面面积分别由C_5的14.0±1.37mm、21.0±1.83mm逐渐增加到C_8的24.2±2.68mm、30.3±3.93mm，各椎间孔外口处臂丛神经断面面积比上椎间孔外口面积均约为1／3；臂丛神经前根根丝数目C_5最多，达10.1±3.3，后根根丝数目C_6最多，达9.7±3.5，二者向下均逐渐减少；前后根的长度分别从C_5的15.62±1.88mm、12.73±1.77mm逐渐增加到T_1的22.33±2.16mm、22.00±2.08mm，且相应的前根比后根要长；前后根A段和B段的长度，均从C_5到T_1逐渐增加；前根与脊髓纵轴的夹角从C_5的60.25°逐渐变小到T_1的30.03°。 [结论]1．椎间孔处韧带对神经根有固定作用，，在神经根断裂的发生中起着至关重要的作用，并且该结构决定着臂丛神经损伤的分型。2．本实验结果提示：神经根型颈椎病是否发生，其症状的严重程度，并不取决于椎间孔截面面积的绝对值大小，而是由椎间孔截面面积与椎间孔处臂丛神经断面面积比决定的。3．本实验对椎间孔内口处臂丛神经断面面积的测量，为发生于椎间孔内口处的神经根型颈椎病在影像诊断中神经根受压程度的定量判断提供解剖学参数。
[Abstract]:[objective] to observe the morphology and characteristics of the anterior and posterior roots of the brachial plexus nerve in the spinal canal, and to elucidate the spatial relationship between the anterior and posterior roots of the brachial plexus nerve and the intervertebral foramen and its significance. To provide anatomical basis for diagnosis and treatment of brachial plexus root avulsion and nerve root type cervical spondylosis. [methods] Fifteen specimens of normal human spine were collected. Open cervical canal, expose bilateral brachial plexus nerve, measure the area of brachial plexus nerve in internal and external orifice of intervertebral foramen, the area of external orifice of intervertebral foramen and the upper and lower diameter of intervertebral foramen, anteroposterior diameter; The number and length of the branches of the anterior and posterior roots of the C_5-T_1 nerve in the spinal canal, the angle between the anterior root of the C_5-T_1 nerve and the longitudinal axis of the spinal cord, and the distance from the beginning of the anterior and posterior roots to the median sulcus of the spinal cord were measured. [results] the measurement of the area of brachial plexus nerve section in intervertebral foramen and external orifice showed that C _ 5 to C _ S _ 8 increased gradually, and T _ 1 nerve root was the thinnest. The area of brachial plexus in intervertebral foramen increased from 14.0 卤1.37 mm to 24.2 卤2.68 mm and 30.3 卤3.93 mm, respectively, from 14.0 卤1.37 mm to 24.2 卤2.68 mm 卤3.93 mm, respectively. The area of brachial plexus at the external orifice of intervertebral foramen was about 1 / 3 of that at the external orifice of superior intervertebral foramen. The number of anterior root filaments of brachial plexus was the highest (10.1 卤3.3), and the number of posterior root filaments of C _ (6) was the highest (9.7 卤3.5). The length of anterior and posterior roots increased from 15.62 卤1.88 mm / 1.77mm to 22.33 卤2.16 mm and 22.00 卤2.08 mm respectively, and the length of anterior root was longer than that of posterior root. The length of A and B segments of the anterior and posterior roots increased from C _ 5 to T _ S _ 1, and the angle between the anterior root and the longitudinal axis of the spinal cord gradually decreased from 60.25 掳of C _ 5 to 30.03 掳of T _ 1. [conclusion] 1. Ligaments at intervertebral foramen play an important role in nerve root fixation and play an important role in the occurrence of nerve root rupture. 2. And this structure determines the type of brachial plexus nerve injury. 2. The results suggest that the severity of the symptoms does not depend on the absolute value of the cross-sectional area of intervertebral foramen. It was determined by the ratio of the cross-sectional area of intervertebral foramen to the area of brachial plexus at intervertebral foramen. 3. To provide anatomical parameters for quantitative determination of the degree of nerve root compression in imaging diagnosis of cervical spondylopathy with nerve root occurring at the interforaminal orifice.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R322

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