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目的探讨枕下极外侧入路与椎动脉相关的显微解剖结构比较。方法采用甲醛固定的成人头颅标本15例,进行模拟枕下极外侧入路的显微解剖手术,测量各重要结构的体表投影数值及椎动脉颅内段行程等相关参数。结果该入路中主要的解剖结构有:寰枕关节及其周围结构、椎动脉第Ⅱ～Ⅳ段走行、颅神经根丝及其走行和相互间的关系。其中乙状窦、枕髁和椎动脉是该入路重要的解剖标志,左、右椎动脉直径和长度比较,差异均无统计学意义(P>0.05),83.3%的椎动脉位于舌下神经腹侧,在舌下神经腹侧走行,16.7%的椎动脉穿舌下神经上、下束之间。结论掌握枕下极外侧入路中椎动脉的走行以及该区域重要的解剖标志,对于经枕下极外侧入路的手术成功有重要意义。
Objective To investigate the microsurgical anatomy of vertebral artery associated with the lateral suboccipital approach. Methods Fifteen adult female adult skull specimens fixed with formaldehyde were used to perform microanatomical operations to simulate the lateral approach of the suboccipital pole and to measure the surface projection values of the important structures and the parameters of the intracranial segments of the vertebral artery. Results The major anatomic structures of the approach were: atlanto-occipital joint and its surrounding structures, the second ~ fourth segment of vertebral artery, the cranial nerve root filaments and their relationship with each other. Among them, sigmoid sinus, occipital condyle and vertebral artery were important anatomic landmarks of the approach. There was no significant difference in diameters and lengths of left and right vertebral artery between the two groups (P> 0.05). 83.3% of vertebral arteries were located in hypoglossal nerve Ventral side, walking in the ventral nerve of the hypoglossal nerve, 16.7% of the vertebral artery under the lingual nerve, under the beam. Conclusion To grasp the movement of the vertebral artery and the important anatomical landmarks in the lateral suboccipital lateral approach is of great significance to the successful operation of the suboccipital lateral approach.