椎弓间隙的测量及其临床意义  

THE SPACES INTERARCUALIA AND ITS CLINICAL SIGNIFICANCE

作　　者：孙国刚[1] 欧册华[2] 肖洪文[1] 聂红艺[1] 

机构地区：[1]泸州医学院解剖学教研室,四川泸州646000 [2]泸州医学院附属医院麻醉科,四川泸州646000

出　　处：《泸州医学院学报》2003年第3期219-222,共4页Journal of Luzhou Medical College

摘　　要：目的 :观测胸部椎弓间隙椎板间部径线的最小值和棘突倾斜度同椎管穿刺失败的关系。方法 :40岁以上的尸体 36具。测量胸部椎管穿刺针的倾斜度。经 2 0例尸体脊柱的椎弓根从冠状面锯开。观测比较胸部椎弓间隙椎板间部的中线垂直高度和中线垂直高度中点处的水平宽度。结果 :①椎弓间隙椎板间部的最小垂直高度介于 0 .40～ 4 .1 0 (平均 2 .2 4 )mm ;椎弓间隙椎板间部的最小宽度介于 3 .40～ 8.30 (平均 5 .41 )mm。②有 1 6例标本因出现 1～ 2个椎弓间隙狭窄而穿刺失败 ,其中 5例有黄韧带增生并发韧带钙化或骨质增生。③正入法中线试穿表明 ,T6～ 7、T8～ 9、T1 0～ 1 1 隙和T1 2 ～L1 隙的平均倾斜度分别为 34 .8°、31 .2°、30 .8°、44 .0°。结论 :①椎弓间隙正入法穿刺的最小倾斜角 ,存在于T6～ 1 1 椎之间 ,平均值为 32 .3°;但旁入法穿刺的倾斜角可增大一倍。Objective: To study the main cause of the failure of spinal puncture of the thorax. Methods: Thirty six Chinese adult cadevers(male 30, female 6, aged over 40) were studied. The vertebral columns of 20 cases were sawed through the coronal plane of each part of the vertebral canal from the atlas to the 3rd lumbar vertebra, the V shaped ligaments flava in the anterior part of the spaces interarcualia were excised from the 3rd space to the 21th space at every other interval; then all the widths and the shortest heights of the excised parts were measured. The exploratory punctures of the thorax of 36 cases were operated and the incline of the needle was measured also. Results: The average of the shortest heights of all the cases is 2.24 (0.40～4.10) mm whose positions are different. The average of the minimum widths is 5.41 ( 3.40～8.30)mm. There are 16 cases(44.4%) whose 1～2 spaces interarcualia of the thorax(T 4～11 ) are stenotic because of simple anatomic stenosis, calcification of the ligaments , or hyperosteogeny in the median parts of it, so that the puncture needle could not pass through it. The average incline of the median parts of the spaces interarcualia of thorax is respectively T 2～3 73° (70°～75°), T 4～5 53.5°(42°～63°), T 6～7 34.8° ( 24°～45°), T 8～9 31.2°(17°～45°), T 10～11 30.8°(20°～40°) and T 12 ～L 1 44.0°(40°～46°). Conclusion: ① The minimum average incline of the median parts of the spaces interarcualia , which exist in T 6～11 vertebrae, is 32.3° (17°～45°), but the incline of the lateral parts of it is doubled: 64.7°(46°～81°). ② The main cause of the stenosis of the spaces interarcualia and of the failure of spinal puncture of the thorax is the natural inclining of the spinous process and the anatomic stenosis.

关 键 词：椎弓间隙 解剖学狭窄 椎管穿刺 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]