CT横突孔测量在颈前路手术中预防椎动脉损伤的应用  

作　　者：方斌[1] 路磊[1] 

机构地区：[1]中国医科大学绍兴医院骨科,312030

出　　处：《浙江临床医学》2016年第6期1008-1010,共3页Zhejiang Clinical Medical Journal

摘　　要：目的了解国人横突孔变异的发生率，测量CT上横突孔各径线数据，为颈椎前路手术提供参考。方法根据横突孔内缘与椎体外缘的关系分为椎体外型、椎体内型、中间型三种类型，测量C3-C6横突孔内缘与椎体中线距离等6个参数，比较横突孔两侧及各椎体之间有无区别。结果横突孔椎体外型、中间型及椎体内型分别占83．34％、16．37％、0．29％。左侧横突孔内缘与椎体中线距离为（1．30±0．28）cm、右侧为（1．28±0．30）cm。各椎体双侧横突孔至中线距离均为C3〈C5〈C6、C4〈C5〈C6。结论约0．29％横突孔内缘可能越过椎体外缘至椎体内；除C3、C4椎体之间差异不显著外，C3-C6椎体横突孔间距自上而下逐渐增大；颈椎前路手术过程中术者应仔细做好术前检查，以避免术中的椎动脉损伤。Obejective To know the incidence of transverse foramen variability, and to provide reference for the anterior cervical spine surgery by measuring the track lines of the transverse foramen on CT images. Method In accordance with the relationship between the outer edge of vertebral body and the inner edge of transverse foramen, the transverse foramen was divided into three types： the extra-vertebra type （ Type A ） , the intermediate type （ Type B ） and the intra-vertebra type （ Type C ） . The distance between the inner edge of the transverse foramen and the vertebral body midline （ line ＂d＂ ） , and other parameters were measured on the CT images. Result TypeA, typeB and typeC accounted for 83.34%, 16.37% and 0.29%, respectively.Line ＂d＂ on the left side was （ 1.30 ± 0.28 ） cm, with （ 1.28± 0.30 ） cm on the right side.Mesurement show that line ＂d＂ on both side were C3 〈C5 〈C6, C4 〈C5 〈C6. Conclusion Of about 0.29% fate the inner edge of transverse foramen probably crossed the outer edge of the vertebral body; Except for C3, C4 vertebrae, the transverse foramen inner margin distance at C3-C6 vertebral body gradually increases; The pre-operative examinations should be carefully checked before doing anterior cervical spine surgery as to avoid intraoperative vertebral artery injury, and help guide the surgery.

关 键 词：颈椎 前路 横突孔 椎动脉损伤 

分 类 号：R654.3[医药卫生—外科学]