极限旋转体位对上颈椎椎动脉管腔的影响  

Influence of different end-range upper cervical rotation on the vertebral artery lumen

作　　者：张法尧 冯敏山[2,3] 朱立国 ZHANG Fa-yao;FENG Min-shan;ZHU Li-guo(The Second Department of Orthopedics of Qiqihar Traditional Chinese Medicine Hospital, Qiqihar 161005, China;General Orthopedics Department, Wangjing Hospital of CACMS, Beijing 100102, China;Key Laboratory of Beijing of TCM Bone Setting, Beijing 100102, China)

机构地区：[1]齐齐哈尔市中医院南院骨二科,黑龙江齐齐哈尔161005 [2]中国中医科学院望京医院,北京100102 [3]中医正骨技术北京市重点实验室,北京100102

出　　处：《中国临床解剖学杂志》2018年第1期71-76,共6页Chinese Journal of Clinical Anatomy

摘　　要：目的使用CT血管成像技术研究极限旋转体位对上颈椎椎动脉管腔的影响。方法取8具新鲜成人尸体上颈椎（C0-4）标本,制作成椎动脉离体模型,颅骨端模块固定3 kg模拟颈椎立位载荷,椎动脉注入造影剂,在实验台上实现立位状态下中立位、多旋转极限体位并使用万向外固定架固定,进行CT薄层扫描,采集C1节段、C1/C2间隙节段、C2椎体上1/3段（寰枢椎侧块关节外侧）、C2椎体下缘、C3椎体节段等5个层面的椎动脉横截面积。比较组间差异,探讨失神经体液调节下体位因素对椎动脉空间形态作用机制。结果颈椎旋转极限及后伸旋转极限体位会引起同侧椎动脉截面积减少（P〈0.05）,而对侧椎动脉截面积无明显改变（P〉0.05）,并且横截面积减少部位集中出现在C2椎体上1/3处。结论 （1）上颈椎离体椎动脉模型及试验方法能实现极限旋转体位下椎动脉管腔CTA的测量;（2）在失神经体液调节下,颈椎极限旋转及极限后伸旋转体位能引起同侧椎动脉狭窄,狭窄部位主要集中在寰枢椎侧块关节外侧。Objective To analyze the influence of different end-range cervical rotation on the vertebral artery lumen with CTA. Methods To trim 8 fresh cervical adult specimens with upper cervical spine（C_（0-4）） is used to build the vitro model loaded 3 kg of vertebral artery. Contrast agent is injected into vertebral artery and the vertebral artery cross-sectional area in the section（C1,C_（1/2）, upper part of C2 vertebral body 1/3, lower part of C2 vertebral body,C3） of the cervical spine were measured by CT in the end-range cervical positions fixed by gimbal mounting： The data were analyzed to study the mechanism of action of vertebral artery space form out of neurohumoral regulation control. Results The end-range rotation and the end-range extension rotation caused homolateral vertebral artery stenosis（P〈0.05）, not on heterolateral（P〉0.05）, and narrow areas always appeared on upper part of C2 vertebral body 1/3. Conclusion（1）The composite vitro vertebral artery model loaded can be used to analyze the influence of different end-range cervical rotation on the vertebral artery lumen with CTA;（2） The end-range rotation and the end-range extension rotation caused homolateral vertebral artery stenosis out of neurohumoral regulation control, and narrow areas always appeared on upper part of C2 vertebral body 1/3（The outside of the atlantoaxial lateral mass）.

关 键 词：上颈椎 旋转极限体位 椎动脉 管腔 CT血管成像技术 

分 类 号：R318.01[医药卫生—生物医学工程]