摘要
目的探讨后路经皮内窥镜下颈椎椎间盘切除术的安全范围。方法选取20具成人颈椎标本,分别测量C3/C4至C6/C7各节段左右两侧V点与硬脊膜外侧距离、V点与椎动脉水平及垂直距离、小关节面宽度,并进行统计学比较。结果 V点与硬脊膜外侧距离为:左(1.31±0.32)^(2.46±0.60)mm,右(1.29±0.35)^(2.75±0.45)mm,各节段间差别有统计学意义,同一水平左右差别无统计学意义;V点与椎动脉水平距离为:左(2.17±0.42)^(5.10±0.93)mm,右(1.99±0.39)^(5.00±0.71)mm,各节段间差别有统计学意义,同一水平左右差别无统计学意义;V点与椎动脉垂直距离为:左(11.05±1.06)^(13.47±1.12)mm,右(11.33±1.20)^(13.61±1.01)mm,同一水平左右侧差别有统计学意义,节段间比较C3/C4与C4/C5无明显差异,其余节段间差别均有统计学意义;小关节面宽度为:左(10.79±0.93)^(12.66±0.88)mm,右(10.86±0.68)^(12.54±0.70)mm。结论后路经皮内窥镜下颈椎椎间盘切除术的安全范围宜控制在距V点内侧C3/C4至C6/C7各水平1.20~2.00 mm;磨除范围距V点外侧C3/C4至C6/C7各水平超过2.00~5.00 mm时可能到达椎动脉体表投影处,因此需注意此时的手术进入深度宜控制在:C3/C4~C6/C7各节段距V点11.00~14.00 mm。
Objective To explore the safety operation area of posterior percutaneous endoscopic cervical discectomy. Methods 20 adult cervical spine specimens were taken to measure the distances between the V-point and the lateral spine dura mater, the horizontal and vertical distances between the V-point and the vertebral artery, and the width of the facet joints on the left and right sides of C3/C4 to C6/C7 respectively. Statistical comparison of the data was made. Results The distance between the V point and the lateral spine dura mater was: left(1.31±0.32~2.46±0.60) mm;right(1.29±0.35~2.75±0.45) mm. There was no statistical difference between left and right of the same level, but there was statistical difference among different segments. The horizontal distance between point V and vertebral artery was: left(2.17±0.42~5.10±0.93) mm, right(1.99±0.39~5.00±0.71) mm. There was no statistical difference between left and right of the same level, but there was statistical difference among different segments. The vertical distance between point V and vertebral artery was: left(11.05±1.06~13.47±1.12) mm, right(11.33±1.20~13.61±1.01) mm. There was statistical difference between left and right of the same level,but no statistical difference among the segment of C3/C4 and C4/C5. The width of facet joints was: left(10.79±0.93~12.66±0.88)mm,right(10.86±0.68~12.54±0.70) mm. Conclusions The safety operation area of posterior percutaneous endoscopic cervical discectomy should be controlled within the range of 1.20~2.00 mm from C3/C4 to C6/C7 on the medial side of the V-point. When the grinding range is more than 2.00~5.00 mm from the C3/C4 to C6/C7 on the lateral side of the V-point, it may reach the body surface projection of vertebral artery. Therefore the depth of surgical entry should be controlled at 11.00~14.00 mm from segments of C3/C4~C6/C7 to the V-point.
作者
曹禹文
刘由军
袁佳
江凯燕
徐聪
CAO Yu-wen;LIU You-jun;YUAN Jia;JIANG Kai-yan;XU Cong(Department of Orthopedics,the Fourth Affiliated Hospital of Nanchang University,Nanchang 330003,Jiangxi Province,China;Department of Radiology,the Fourth Affiliated Hospital of Nanchang University,Nanchang 330003,Jiangxi Province,China;Fourth Clinical Medical College of Nanchang University,Nanchang 330027,Jiangxi Province,China)
出处
《中国临床解剖学杂志》
CSCD
北大核心
2020年第3期246-249,共4页
Chinese Journal of Clinical Anatomy
基金
江西省自然科学基金项目(20151BAB205052)。
关键词
颈椎
后路
应用解剖
内窥镜
V点
Cervical vertebra
Posterior
Applied anatomy
Endoscope
V-point
