摘要
目的研究颈胸段脊柱前方手术入路时颈交感干和颈长肌的相互关系及其临床意义.方法12例意外死亡的正常成人尸体标本,测量C4～T2椎体水平两侧颈长肌内侧缘至脊柱前方正中线的距离,每一椎体节段测量水平为椎体前缘上下连线中点水平;测量颈交感干包括颈中神经节与中线的距离,以及与颈长肌内侧缘的距离;测量颈长肌附着点的位置变化.结果颈长肌内侧缘至颈胸段脊椎前方中线的距离自上而下逐渐增宽,分别为(mm):C3水平5.5±1.2,C4水平6.1±0.6,C5水平6.5±1.4,C6水平6.2±1.9,C7水平7.0±0.5,T1水平7.8±2.3,T2水平12.0±2.5.12例颈长肌起点的位置均在T1～T3,7例(58.3%)基本为白色腱性组织,5例(41.6%)为肌肉组织或和腱性组织混合组成.颈交感干与中线的距离分别为(mm):C3水平23.0±2.0,C4水平22.0±4.0,C5水平19.0±3.0,C6水平15.0±4.0,C7水平16.0±3.0.颈交感干与颈长肌内侧缘在C67水平距离最近,两者距离分别为8.8 mm和9.0 mm.7例(58.3%)发现颈中神经节.结论在C67水平,颈交感干与颈长肌内侧缘距离最近,所以其损伤可能性也最大.熟悉颈交感干和颈长肌的相关解剖有助于在手术中减少可能的神经损伤,同时也助于椎体节段的判断.
Objective To study the anatomic relations between longus colli muscle and sympathetic trunk when performing the anterior approach to the cervicothoracic spine. Methods 12 cadavers were used in this study. All were healthy and died accidently. The distance between the medial border of the longus colli muscle and the prevertebral midline from C 4 to T 2 was measured. The distance between the sympathetic trunk including the middle cervical ganglion and medial border of longus colli muscle, the distance between the sympathetic trunk and the prevertebral midline were recorded, respectively. Results The distance between the medial border of the longus colli muscle and the prevertebral midline increased gradually from upper to lower cervical levels, which was (5.5±1.2) mm at C 3, (6.1±0.6) mm at C 4, (6.5±1.4) mm at C 5, (6.2±1.9) mm at C 6, (7.0±0.5) mm at C 7, (7.8±2.3) mm at T 1, (12.0±2.5) mm at T 2. The muscle attachments of the cases were at T 1~3 level, 7(58.3%) of whom were white tendons tissue and 5 were composition of tendon and muscle tissue. The distance between midline and sympathetic trunk was 23.0±2.0 mm in C 3, 22.04±4.0 mm in C 4, 19.0±3.0 mm in C 5, 15.0±4.0 mm in C 6 and 16.0±3.0 in C 7. The distance from the medial border of the longus colli muscle to sympathetic trunck was smaller at the C 6,7 levels, which were 8.8 mm and 9.0 mm, respectively. The middle cervical ganglion was found in 7 cadavers (58.3%). Conclusions At the C 6, 7 levels, the distance from the medial border of the longus colli muscle to sympathetic trunck was smallest. Awareness of the anatomic relations between longus colli muscle and sympathetic trunk may be helpful to minimize the nerve compromise and to facilitate the vertebral body location during anterior cervical operations.
出处
《临床骨科杂志》
2005年第2期169-171,共3页
Journal of Clinical Orthopaedics
关键词
颈胸段
脊柱
颈长肌
颈交感干
解剖学
cervicothoracic spine
longus colli muscle
sympathetic trunk
anatomy
