【摘要】 颈椎1.2侧方蛛网膜下腔穿刺是近年来用于诊断和治疗神经系统疾病的一项新技术。本文报告52例C1.2侧方穿刺病人,年龄6～56岁。除2例因穿刺方向有误失败外,其余均获成功,成功率达96％。本文结合文献对穿刺术的解剖学基础、基本操作方法及术中异常情况的处理进行了细致分析和讨论。C1.2侧方穿刺操作简单、易行、安全、适用范围广,不需特殊器械,有普通腰穿刺针即可。更多还原

【Abstract】 This paper reports 52 cases of lateral C1-2 puncture. LCP is a new method to diagnose and treat the diseases of the nerve system. It is possible, because at the C_1-2 interspace there is no overlap of the cervical vertebrae laterally at the attantoaxial joint,and there is a wide intervertebral space. LCP is simple to perform and seems to be less potential for major complications than suboccipital puncture. C_1-2 vertabral level is generally accepted as a safe site to obtain cerebrospinal fluid （CSF） or introduce medication or radiographic contrast medium into the subarachnoid space. The patient is placed in the supine position in bed, without a pillow, and with the neck as straight as possible. The landmark for needle insertion is 1 cm caudal and 1cm posterior to the tip of the mastoid process （Figure）. The skin is then sterilized, and a local anesthetic is injected at the site. A standard lumbar puncture needle （usually 7 or 9 gauge） is inserted parallel to the plane of the bed and perpendicular to the neck. The contraindication for LCP are local infection, bone damage, increased intracranial pressure with cerebral herniation, and so on.更多还原