颈椎椎间孔外口区韧带的解剖学观测  

Anatomical observation of the extraforaminal ligaments of the cervical spine

作　　者：高强 范磊[1] 李晓彬[1] 蔡腾[1] 赵健军 赵庆豪 刘涛[1] Gao Qiang;Fan Lei;Li Xiaobin;Cai Teng;Zhao Jianjun;Zhao Qinghao;Liu Tao(Henan Provincial People's Hospital,Zhengzhou 450003,China;The Third Affiliated Hospital of Southern Medical University,Guangzhou 510000,China)

机构地区：[1]河南省人民医院,郑州450003 [2]南方医科大学第三附属医院,广州510000

出　　处：《中国临床解剖学杂志》2021年第4期375-378,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的对颈椎C_(2~7)椎间孔外口区域的韧带进行解剖学描述并探讨其临床意义。方法对10具成人尸体标本的100个椎间孔进行解剖观测。鉴别所有出现的韧带,观察并记录C_(2~7)椎间孔外口区域椎间孔外韧带的数量、形态、分布和起止位置。并用游标卡尺分别测量每条韧带的长度、宽度和厚度。结果在100个椎间孔外口区域共发现252个椎间孔外韧带。椎间孔外韧带可以分为放射型韧带236个(93.7%)和横跨型韧带16个(6.3%)两种。放射型韧带将神经根连接到周围结构,可分为上方韧带(25.0%),下方韧带(60.2%),前方韧带(6.3%)和后方韧带(8.5%);横跨型韧带与神经根相垂直并横跨于神经根上,其中,横跨型韧带在C_(4~5)节段最为常见,在C_(4~5)节段的平均长度为横跨型韧带长度为(8.12±1.38)mm(6.28~9.93 mm),厚度最厚可达1.04 mm,每个颈椎椎间孔最多只有一条横跨型韧带。结论椎间孔外韧带是椎间孔正常的生理结构,可能与颈椎减压术后C5神经麻痹的发生有关。在颈椎减压术后,横跨型韧带可能是造成神经根卡压而引起神经损伤的潜在原因之一。而放射型韧带可以限制脊神经移位,可能因此牵拉神经引起损伤。Objective To describe the extraforaminal ligaments in the exit regions of the C_(2~7) intervertebral foramina and to discuss their possible clinical significance.Methods A total of 100 C_(2~7) intervertebral foramina from 10 adult cadavers were anatomically observed.All the ligaments that appeared were identified.The number,morphology,distribution,starting and ending position of the ligaments were observed and recorded.The length,width and thickness of each ligament were measured by vernier calipers.Results There were 252 extraforaminal ligaments in the 100 intervertebral foramina.The extraforaminal ligaments could be divided into radioactive ligaments(236pcs,accounting for 93.7%)and transforaminal ligaments(16pcs,accounting for 6.3%).Radioactive ligaments,which connected the nerve root to the surrounding structures,could be divided into superior ligaments(accounting for 25.0%),inferior ligaments(accounting for 60.2%),anterior ligaments(accounting for 6.3%)and posterior ligaments(accounting for 8.5%).The transforaminal ligaments were perpendicular to the nerve root and straddled the nerve root.The transforaminal ligaments were the most common in C_(4~5) ligaments.The average length of the transforaminal ligaments at C_(4~5) intervertebral foramina was(8.12±1.38)mm(6.28~9.93 mm),and the thickest was 1.04 mm.There was one transforaminal ligament at most per cervical foramina.Conclusions The extraforaminal ligaments is a normal physiological structure of intervertebral foramen and may be related to the occurrence of C5 nerve palsy after cervical decompression surgery.After cervical decompression surgery,the transforaminal ligaments may be one of the potential causes of nerve root entrapment and nerve injury.The radioactive ligament could limit the displacement of spinal nerves and may cause nerve injury by traction.

关 键 词：椎间孔外韧带 颈椎椎间孔 解剖 神经卡压 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]