枕下极外侧入路椎动脉的显微解剖结构观察  

Observation of microsurgical anatomy of vertebral artery on the suboccipital extreme lateral approach

作　　者：唐景峰[1] 黄永旺[1] 杜贻庆[1] 杨保华[1] 阳永东[1] 夏学巍[1] 唐乐剑[1] 周晓坤[1] 王文波[1] 莫万彬[1] 

机构地区：[1]桂林医学院附属医院神经外科,广西桂林541001

出　　处：《重庆医学》2013年第3期241-242,245,共3页Chongqing medicine

基　　金：桂林市科学研究与技术开发计划项目(20100315-2);广西区教育厅科研计划课题[桂科教(2004)20]

摘　　要：目的探讨枕下极外侧入路与椎动脉相关的显微解剖结构比较。方法采用甲醛固定的成人头颅标本15例,进行模拟枕下极外侧入路的显微解剖手术,测量各重要结构的体表投影数值及椎动脉颅内段行程等相关参数。结果该入路中主要的解剖结构有:寰枕关节及其周围结构、椎动脉第Ⅱ～Ⅳ段走行、颅神经根丝及其走行和相互间的关系。其中乙状窦、枕髁和椎动脉是该入路重要的解剖标志,左、右椎动脉直径和长度比较,差异均无统计学意义(P>0.05),83.3%的椎动脉位于舌下神经腹侧,在舌下神经腹侧走行,16.7%的椎动脉穿舌下神经上、下束之间。结论掌握枕下极外侧入路中椎动脉的走行以及该区域重要的解剖标志,对于经枕下极外侧入路的手术成功有重要意义。Objective To discuss the microsurgical anatomy of vertebral artery on the suboccipital extreme lateral approach.Methods Fifteen cadaveric fixed heads were operated under operating-microscope and the related parameters were measured by simulating the suboccipital extreme lateral approach.Results The structures observed in this approach included：the structures around atloido-occipital joint,the course of the superior part of the Ⅱ-Ⅳ segments of vertebral artery,The course and interrelationship of posterior cranial nerves.Sigmoid sinus,occipital condyle and vertebral artery were the important anatomic landmark in this approach.Left and right vertebral artery diameter and length were not significantly different（P〉0.05）.83.3% of the vertebral artery passed through the ventral side of the hypoglossal nerve,16.7% of the vertebral artery passed through the hypoglossal nerve between the upper and lower beam.Conclusion It is important that to master the traveling of vertebral artery and the dissection mark of this region,which is successful for surgery by suboccipital extreme lateral approach.

关 键 词：枕下极外侧入路 椎动脉 解剖 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]