颈椎前路减压植骨术中预防交感神经干损伤的基础与临床研究  

Vulnerability of the sympathetic trunk during the anterior decompression of the cervical spine

作　　者：张英泽[1] 王庆贤[1] 潘进社[1] 薛静 李亚洲[1] 

机构地区：[1]河北医科大学第三医院创伤急救中心 [2]河北省石家庄市第一人民医院

出　　处：《中国脊柱脊髓杂志》2004年第3期153-155,共3页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:对颈交感神经干的走行及其毗邻关系进行定量解剖学研究,为预防在颈前部手术特别是颈椎前路减压植骨术中误伤交感神经干提供依据.方法:采用成年尸体20具,去除颈部浅层肌肉及软组织,显露双侧颈长肌及交感神经干,测量C3～C7颈交感神经干与颈长肌内缘的距离、颈长肌内缘夹角以及交感神经干与中线的夹角、交感神经干与颈椎椎体中央的距离,并将该数据应用于临床.结果:①交感神经干呈斜行走向,同中线夹角为11.2°±4.7°.双侧颈长肌内缘夹角为13.1°±3.2°.②颈交感神经干与颈长肌内缘的距离分别为:C325.5±2.8mm,C4 20.4±3.5mm,C5 17.8±2.9mm,C6 10.2±2.4mm,C7 15.3±3.1mm.③颈交感干与颈椎椎体中央的距离分别为:C3 29.1±3.2mm;C4 25.2±2.9mm,C5 23.4±2.7mm,C6 16.4±3.0mm,C7 21.7±4..6mm.④用该数据指导临床手术11例,经半年至6年随访,无一例损伤交感神经干,也未见其它合并症.结论:交感神经干与颈长肌内缘及椎体中央的距离在C6水平最小,颈椎前路减压手术时应注意保护交感神经干.Objective:To prevent the injury of the sympathetic trunk(ST)during the anterior neck operation especially the anterior decompression of the cervical spine,an anatomical study on the course and adjacent relationship of ST was done.Method:20adult cadavers were used for dissection and measurements.The distance between the sympathetic trunk(ST)and the medial border of the longus collis muscle(LCM)from C3to C7level and the distance between the ST and the center of the cervical body from C3to C7level were measured.The angle of the sympathetic trunk to the midline was determined bilaterally.The angle between the medial border of the longus collis muscle was also measured.Result:①The sympathetic trunk(ST)runs in a superior and lateral direction,with an average angle of11.2°±4.7°relative to the midline and the angle between the medial border of the longus collis muscle was13.1°±3.2°.②The distance between the ST and the medial border of the LCM was25.5±2.8mm at C3,20.4±3.5mm at C4,17.7±2.9mm at C5,10.2±2.4mm at C6and15.3±3.1mm at C7.③The distance between the ST and the center of the cervical body was29.1±3.2mm at C3,25.2±2.9mm at C4,23.4±2.7mm at C5,16.4±3.0mm at C6and21.7±4.6mm at C7.④We performed operations on11cases under the guideness of the above data.These cases had follow-up from six months to six years.No ST injury was found,no other complications were observed.Conclusions:The distances between ST and the medial border of the LCM or the center of the vertebral body are the shortest at C6.ST should be protected in the anterior decompression of the cervical spine.

关 键 词：颈椎前路减压植骨术 预防 交感神经干损伤 临床研究 

分 类 号：R651.3[医药卫生—外科学] R322.8[医药卫生—临床医学]