单切口经颈椎后路硬膜外入路健侧颈7神经移位手术的解剖学研究  

Anatomical study on single-incision posterior cervical epidural transfer surgery on the healthy side of the seventh cervical nerve

作　　者：严正村 顾加祥 刘宏君 罗文苗 王晓东 魏民 王永祥[3] 张恒柱 Yan Zhengcun;Gu Jiaxiang;Liu Hongjun;Luo Wenmiao;Wang Xiaodong;Wei Min;Wang Yongxiang;Zhang Hengzhu(Department of Neurosurgery,Northern Jiangsu People′s Hospital,Yangzhou 225001,China;Department of Hand Surgery,Northern Jiangsu People′s Hospital,Yangzhou 225001,China;Department of Orthopedics,Northern Jiangsu People′s Hospital,Yangzhou 225001,China)

机构地区：[1]苏北人民医院神经外科,扬州225001 [2]苏北人民医院手外科,扬州225001 [3]苏北人民医院骨科,扬州225001

出　　处：《中华神经外科杂志》2025年第1期73-77,共5页Chinese Journal of Neurosurgery

基　　金：扬州市科技计划——社会发展(YZ2023108)。

摘　　要：目的通过解剖学研究探讨实施单切口经颈椎后路硬膜外入路健侧颈7神经移位手术的可行性。方法选取5具新鲜的头颈部标本,模拟单切口经颈椎后路硬膜外入路行健侧颈7神经移位手术,显微镜下观察手术相关的解剖标志及其与周边结构的解剖关系,测量并分析相关解剖数据。结果在5具标本上均顺利完成经颈椎后路硬膜外入路健侧颈7神经移位手术。颈7神经与颈7椎体横突平面的垂直距离为(2.6±0.3)cm(2.3~3.0 cm),颈7神经与脊柱垂直线的夹角为(65.5±1.5)°(63.0°~67.5°)。颈7神经根的远端分为前股和后股,颈7神经根椎间孔外段的长度为(6.4±0.4)cm(6.0~6.9 cm)。通过椎间孔内口引出的颈7神经的长度为(7.8±0.3)cm(7.4~8.2 cm)。硬膜外入路颈7神经移位所需的最短距离为(3.3±0.3)cm(3.0~3.6 cm)。结论初步解剖学研究表明,采用单切口经颈椎后路硬膜外入路健侧颈7神经移位手术是可行的,该方法无需桥接神经,为临床上椎管内硬膜外入路健侧颈7神经移位手术的实施提供了理论依据。Objective To explore the feasibility of ipsilateral C7 nerve transfer via a single-incision posterior cervical epidural approach through anatomical studies.Methods Five fresh cadaveric head and neck specimens were selected to simulate the ipsilateral C7 nerve transfer surgery via a single-incision posterior cervical epidural approach.Surgery-related anatomical markers and their relationships with surrounding structures were observed under a microscope,and relevant anatomical data were measured and analyzed.Results The ipsilateral C7 nerve transfer surgery via a posterior cervical epidural approach was successfully completed in all five specimens.The vertical distance between the C7 nerve and the plane of the C7 transverse process was 2.6±0.3 cm(range:2.3-3.0 cm),and the angle between the C7 nerve and the vertical line of the cervical vertebrae was 65.5±1.5 degrees(range:63.0-67.5 degrees).The distal end of the C7 nerve root was separated into the anterior and posterior femurs,and the length of the C7 nerve root in the outer segment of the intervertebral foramen was 6.4±0.4 cm(range:6.0-6.9 cm).The C7 nerve was introduced through the inner opening of the intervertebral foramen,and its length was 7.8±0.3 cm(range:7.4-8.2 cm).The shortest distance for transfer of the C7 nerve through the epidural pathway was 3.3±0.3 cm(range:3.0-3.6 cm).Conclusions Preliminary anatomical studies have demonstrated the feasibility of ipsilateral C7 nerve transfer via a single-incision posterior cervical epidural approach without the need for nerve grafting.This provides a theoretical basis for the feasibility of intraspinal epidural approach for C7 nerve transfer surgery.

关 键 词：神经移位 模型 解剖学 颈7神经 可行性 

分 类 号：R68[医药卫生—骨科学]