健侧C_7神经根移位经椎体前通路的应用解剖及临床研究  

The anatomical and clinical study of contralateral C_7 transfer through the prespinal route

作　　者：王树锋[1] 胡琪[1] 王海华[1] 苏彦农[1] 赵俊会[1] 常万绅[1] 

机构地区：[1]北京积水潭医院手外科,100035

出　　处：《中华手外科杂志》2003年第2期69-71,共3页Chinese Journal of Hand Surgery

摘　　要：目的　通过尸体解剖及临床手术 ,找到健侧C7神经移位修复臂丛损伤的最佳桥接神经通路。方法　对 8具成人颈段尸体标本 ,显露双侧臂丛神经 ,将右侧C7神经在干股交界处切断并游离至椎孔处 ,经前斜角肌的深面翻转至椎体前 ,测量C7神经根至对侧臂丛上干前后股的距离。临床选择 13例臂丛神经撕脱伤患者 ,术中测量健侧C7神经根经椎体前及颈前皮下通路修复患侧臂丛上干或前后股的距离 ,并对其手术入路进行观测。结果　尸体标本测量C7神经根经椎体前通路至对侧臂丛上干前后股的距离平均为 ( 7.9± 2 .6)cm , x±s,下同。临床测量健侧C7神经根经椎体前通路及颈前皮下通路至对侧臂丛上干或前后股的距离分别为 ( 9.4± 1.2 )cm及 ( 18.2± 3 .2 )cm。两组相比差异有显著意义 (P<0 .0 1)。临床应用 13例全部取得成功 ,无并发症出现。结论　经椎体前通路是健侧C7神经移位修复臂丛损伤的最佳桥接神经通路之一。Objective To find the optimal route of contralateral C 7 nerve transfer for brachial plexus avulsion injuries through anatomical and clinical study. Methods The bilateral brachial plexus were exposed on 8 cadaveric specimens of adult. The C 7 nerve root at the right side was sectioned at the junction site of trunk and division and dissected proximally to the foramina and reversed to the left side through the prespinal route. The distance between C 7 root and the original site of anterior and posterior division of upper trunk of the left side was measured. The length of the nerve grafting that bridge the contralateral C 7 to the upper trunk at the affected side through prespinal route and a subcutaneous tunnel on the anterior surface of the neck was also measured in 13 pattients with brachial plexus root avulsion injury. Results The average distance of contralateral C 7 to the junction site of trunk and division of upper trunck through prespinal route was 7.9±2.6 cm on cadaveric specimens. The distance of contralateral C 7 transfer to the upper trunk at the affected side through prespinal route and through a subcutaneous tunnel on the anterior surface of the neck measured on patients was 9.4±1.2 cm and 18.2±3.2 cm respectively, with a significant difference. The operation was successful and no complication occurred. Conclusions One of the best way of nerve grafting of contralateral C 7 nerve transfer for brachial plexus injury was through the prespinal route.

关 键 词：健侧C7神经根移位 椎体前通路 解剖学 臂丛神经损伤 

分 类 号：R322.8[医药卫生—人体解剖和组织胚胎学]