颈椎病发生的颈交感干及颈神经后支的解剖学因素观察  

Anatomical basis and clinical significance of cervical dorsal rami nerve and cervical sympathetic trunk caused cervical disk diease

作　　者：夏武宪[1] 张雁儒[2] 孟庆军[3] 

机构地区：[1]郑州铁路职业技术学院,河南郑州450052 [2]郑州大学基础医学院,河南郑州450001 [3]郑州大学第一附属医院,河南郑州450001

出　　处：《中国现代医学杂志》2009年第11期1735-1738,共4页China Journal of Modern Medicine

摘　　要：目的了解颈交感干及颈神经后支的解剖学特点及其与颈椎周围组织的解剖关系,为临床诊治椎间孔外颈神经压迫提供解剖学基础。方法解剖28具(56侧)成人尸体标本,观察颈交感干及颈神经后支与周围组织结构的解剖关系,测量前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带外缘与颈交感神经干的距离。结果C1颈神经后支走行于寰椎与枕骨之间,C2颈神经后支内侧支(枕大神经)穿上项线处骨纤维孔分布于颅顶,C3-8颈神经后支自椎间孔分出后,分别经骨纤维孔进入骨纤维管,然后穿颈后肌群的腱性交叉纤维,分布于颈椎关节突关节、项部肌肉及枕部皮肤。颈下(星状)神经节下端紧贴第一肋椎关节。前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带均为腱性结合。结论颈神经后支穿行的骨纤维孔、骨纤维管及项部肌群的腱性交叉纤维是造成椎间孔外颈神经后支压迫的解剖学基础;颈上交感神经节周围肿大的淋巴结、颈下(星状)神经节下端增生的第一肋椎关节、前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带是造成颈交感干在椎间孔外压迫的解剖学因素。[Objectives] To study the anatomic characteristics of cervical sympathetic trunk and cervical dorsal rami nerve and their anatomic relationship with the adjacent tissues of the cervical vertebrae in order to provide anatomic basis for the diagnosis and treatment of the cervical nerve compression syndrome at external intervertebral foremen. [Methods] Both sides of 28 Chinese adult cadavers were dissected to observe the anatomic relationship of cervical sympathetic trunk and cervical dorsal rami nerve with the adjacent tissues. The distance between the tendinous decussate origins of the scalenus anticus, the external edges of the tendinous girdles of the musculus longus capitis and the musculus longus colli and the cervical sympathetic trunk was measured. [Rusults] The C, dorsal ramus passed between atlas and occipital bone.The medial branch of C2 dorsal ramus （the greater occipital nerve） passed through the osteo-fibruos aperture near the superior nuchal line and spreaded across the top of the skull.After arising outside their respective intervertebral foramina, C1-8 dorsal rami passed through osteo-fibruos aperture, entered the osteo-fibruos canal, passed through the tendious deeussating fibers of the posterior muscles of neck and then supplied the cervical zygapophysial joints, the nuchal muscles and the occipital skin. The tumescent lymph nodes were foud around the superior cervical sympathetic ganglia. The inferior extremity of the inferior cervical ganglia （stellate ganglia） was adjacent to the first costovertebral joint. The tendinous decussating origins of the scalenus anticus and the tendinous girdles of the musculus longus capitis and the musculus longus colli were all tendious tissue. [Conclusions] The osteo-fibrous apertures, osteo-fibrous canal and the tendious decussating fibers of the nuchal muscles passed through by cervical dorsal rami are anatomic basis of the cervical dorsal rami compression syndrome. Superior cervical sympathetic ganglia, the hyperplastic first costovertebral joint adjac

关 键 词：颈椎病 颈交感干 颈神经后支 压迫 解剖学因素 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]