后结节为针刀靶点治疗神经根型颈椎病的机制研究
发布时间：2019-04-28 20:42
【摘要】：目的从解剖学角度解析颈椎横突后结节为针刀靶点治疗神经根型颈椎病(CSR)的作用机制。方法31侧CSR患者,侧卧,针刀靶向横突后结节,松解其周围结构。治疗10 d后,复查患者症状、体征及颈椎X线变化。解剖观察6具12侧成年尸体颈椎横突后结节周围结构与脊神经根的关系。结果治疗10 d后,上肢麻木、疼痛症状明显减轻或消失者占83.9%;臂丛神经牵拉和椎间孔挤压试验转阴率分别为84.2%和75.0%;X线检查显示,横突间距和椎间外孔纵距分别增宽5.24%和15.87%。尸体解剖发现,横突后结节位于脊神经根后外侧,其前方和侧方主要为中、后斜角肌及肩胛提肌腱附着。部分起自前结节的中、后斜角肌及肩胛提肌腱,以及前斜角肌腱均跨越脊神经沟后合并到后结节。相邻后结节间有明显韧带连结。结论横突后结节为针刀靶点治疗CSR的作用机制可能是解除后结节周围的肌腱和韧带对神经根的压迫。
[Abstract]:Objective to analyze the mechanism of (CSR) treatment of cervical spondylotic radiculopathy by using posterior tubercle of transverse process of cervical spine as a target of needle knife from anatomical point of view. Methods 31 sides of CSR patients, lying side, needle-knife targeted posterior transverse tubercle, loosened the surrounding structure. After 10 days of treatment, the symptoms, signs and X-ray changes of cervical spine were reviewed. The relationship between the structures around the posterior tubercle of the transverse process of cervical spine and the spinal nerve roots in 6 adult cadavers was observed. Results after 10 days of treatment, 83.9% of the patients suffered from numbness and pain relief, and 84.2% and 75.0% of the patients had brachial plexus traction and intervertebral foramen extrusion test, respectively, and the negative rate of brachial plexus traction and intervertebral foramen extrusion test were 84.2% and 75.0%, respectively. X-ray examination showed that the distance between transverse process and lateral foramen increased by 5.24% and 15.87%, respectively. The posterolateral tubercle of the transverse process was found to be located in the posterolateral part of the spinal nerve root, and the anterior and lateral nodes were mainly middle, posterior trapezius muscle and levator scapularis tendon attached. The posterior trapezius muscle, the levator scapularis tendon, and the anterior trapezius tendon all cross the spinal sulcus and merge into the posterior tubercle. There are obvious ligamentous connections between adjacent posterior nodules. Conclusion the therapeutic mechanism of posterior transverse tubercle for CSR may be to relieve the compression of nerve roots by tendons and ligaments around the posterior tubercle.
【作者单位】： 贵州省遵义市第二人民医院疼痛科;遵义医学院附属医院药剂科;贵州省遵义医学院人体解剖学教研室;贵州省遵义市第二人民医院放射科;
【基金】：国家自然科学基金应急管理项目(No:31540031) 贵州省遵义市科技局社会攻关项目(No:2013-49)
【分类号】：R246.9
，
本文编号：2467953
[Abstract]:Objective to analyze the mechanism of (CSR) treatment of cervical spondylotic radiculopathy by using posterior tubercle of transverse process of cervical spine as a target of needle knife from anatomical point of view. Methods 31 sides of CSR patients, lying side, needle-knife targeted posterior transverse tubercle, loosened the surrounding structure. After 10 days of treatment, the symptoms, signs and X-ray changes of cervical spine were reviewed. The relationship between the structures around the posterior tubercle of the transverse process of cervical spine and the spinal nerve roots in 6 adult cadavers was observed. Results after 10 days of treatment, 83.9% of the patients suffered from numbness and pain relief, and 84.2% and 75.0% of the patients had brachial plexus traction and intervertebral foramen extrusion test, respectively, and the negative rate of brachial plexus traction and intervertebral foramen extrusion test were 84.2% and 75.0%, respectively. X-ray examination showed that the distance between transverse process and lateral foramen increased by 5.24% and 15.87%, respectively. The posterolateral tubercle of the transverse process was found to be located in the posterolateral part of the spinal nerve root, and the anterior and lateral nodes were mainly middle, posterior trapezius muscle and levator scapularis tendon attached. The posterior trapezius muscle, the levator scapularis tendon, and the anterior trapezius tendon all cross the spinal sulcus and merge into the posterior tubercle. There are obvious ligamentous connections between adjacent posterior nodules. Conclusion the therapeutic mechanism of posterior transverse tubercle for CSR may be to relieve the compression of nerve roots by tendons and ligaments around the posterior tubercle.
【作者单位】： 贵州省遵义市第二人民医院疼痛科;遵义医学院附属医院药剂科;贵州省遵义医学院人体解剖学教研室;贵州省遵义市第二人民医院放射科;
【基金】：国家自然科学基金应急管理项目(No:31540031) 贵州省遵义市科技局社会攻关项目(No:2013-49)
【分类号】：R246.9
，
本文编号：2467953
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