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目的为颈前外侧入路手术提供应用解剖学基础。方法对10具标本模拟右侧颈前外侧入路进行解剖观测。结果颈总动脉的分叉在C4水平为70%。面静脉70%在C3/4椎间盘水平注入颈内静脉。颈交感干位于椎前筋膜下方,行于颈动脉鞘的正后方,并在头长肌和颈长肌表面纵向延伸。C6水平颈交感干和颈长肌内侧缘之间的距离(14.5±4.8)mm,C6水平颈交感干的直径为(2.6±1.2)mm。上神经节位于C2水平,长度和宽度分别是(11.9±2.5)mm和(7.4±4.2)mm。中神经节位于C5水平4例,C6水平6例。长度和宽度分别是(8.9±5.9)mm和(5.1±3.2)mm,椎动脉无一例外都穿过C6横突孔上行。C5的钩突的高度和宽度是最小的,但是从钩突的内侧缘到横突的前结节却拥有最长的距离(P<0.05)。结论采用该入路对于颈椎前外侧的病理性损害具有直达病变部位、损伤小、减压彻底,最大程度上保留病变节段的运动性和脊柱的稳定性等优点。
Objective To provide an anatomical basis for anterior cervical approach. Methods Ten specimens were used to simulate the right lateral anterior cervical approach. Results The carotid artery bifurcation was at C4 level of 70%. 70% of the facial veins are injected into the jugular vein at the level of the C3 / 4 disc. The cervical sympathetic trunk is located just below the anterior vertebral fascia, posterior to the carotid sheath, and longitudinally extends over the surface of the long, long muscle and the long, long muscle. The distance between C6 horizontal cervical intervertebralis and the medial margin of cervical longus muscle was (14.5 ± 4.8) mm, and the diameter of cervical sympathetic trunk was C6 (2.6 ± 1.2) mm. The upper ganglion is located at C2 level with length and width of (11.9 ± 2.5) mm and (7.4 ± 4.2) mm, respectively. In the ganglion in C5 level in 4 cases, C6 level in 6 cases. The length and width were (8.9 ± 5.9) mm and (5.1 ± 3.2) mm, respectively, and all vertebral arteries crossed the C6 transverse ascending. C5 had the smallest height and width of the uncinate process, but had the longest distance from the medial margin of the uncinate process to the anterior tubercle of the transverse processes (P <0.05). Conclusion The pathological lesions of the anteromedial cervical spine have a direct lesion with less damage and thorough decompression. The maximal reserve of the segmental motility and stability of the spine is its advantages.