颈椎前路减压与椎内静脉丛相关的应用解剖学研究

发布时间：2019-06-07 07:36

【摘要】：目的:探讨颈椎前路手术中减压范围与椎内静脉丛出血问题相关的应用解剖学研究。方法:选择6具新鲜尸体和12具经防腐固定的完整的成人颈部标本(C1～T1),对椎体钩突前脚间距、钩突前脚与横突孔内壁垂直距离及椎内前静脉丛两侧纵行血管间距等进行解剖观察。结果:椎内前静脉丛潜行于后纵韧带内,紧贴硬脊膜背面,两条纵行血管间形成横行交通支;在C3～C7相应椎体,钩突内侧缘与横突孔内壁间距为(5.25±0.85)mm,C3～C7相应节段椎内前静脉丛两侧纵行血管间距从(11.13±0.20)mm增大到(14.98±0.27)mm。C3～C7钩突前角间距从(14.60±1.03)mm增大到(21.51±1.91)mm,钩突前后径均大于11mm。结论:颈椎前路手术减压的安全区域可以双侧钩突前角为解剖标志,在此范围内,可完全显露椎内静脉丛两侧纵行静脉,从而有效地处理椎内静脉丛术中出血问题,手术安全,减压彻底。
[Abstract]:Objective: to investigate the applied anatomy of decompression range and intravertebral venous cluster hemorrhage in anterior cervical spine surgery. Methods: six fresh cadavers and 12 intact adult neck specimens (C1~T1) were selected for the distance between the anterior feet of the uncinate process of the vertebral body. The vertical distance between the anterior foot of the uncinate process and the inner wall of the transverse foramen and the distance between the longitudinal vessels on both sides of the anterior venous plexus of the vertebrae were dissected and observed. Results: the anterior venous plexus of the vertebrae was hidden in the posterior longitudinal ligament, close to the back of the dura mater, and the transverse communicating branches were formed between the two longitudinal vessels. In the corresponding vertebral body of C3~C7, the distance between the medial edge of the uncinate process and the inner wall of the transverse foramen was (5.25 卤0.85) mm,. The distance between the longitudinal vessels on both sides of the anterior venous plexus in the corresponding segment of C3~C7 increased from (11.13 卤0.20) mm to (14.98 卤0.27) mm.C3~C7, from (14.60 卤1.03) mm to (21.51 卤1.91) mm,. The diameter before and after the hook process is more than 11 mm. Conclusion: the safe area of anterior decompression of cervical vertebrae can be used as anatomical sign of bilateral uncinate process anterior angle, within which the longitudinal veins of both sides of internal venous plexus can be completely exposed, so as to effectively deal with the problem of intraoperative hemorrhage of intraoperative vertebral venous cluster, and the operation is safe. Decompression is complete.
【作者单位】：南方医科大学研究生学院中国人民解放军广州军区广州总医院骨科中国人民解放军广州军区广州总医院骨科中国人民解放军广州军区广州总医院骨科中国人民解放军广州军区广州总医院骨科
【基金】：2007年卫生部公益性行业科研专项立项项目(2-18)
【分类号】：R322

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