【摘要】 目的测量不同节段颈神经的组成、走行及相应椎间空的特点,以提高颈椎病微创手术的安全性。方法 15例(共30侧)国人成年颈椎标本,进行显微解剖,对颈神经走行、分支、分布进行观测。结果颈椎间孔长度在0.54～0.65cm,且从上到下,椎间孔长度逐渐增加;C4、C5、C6椎间孔的上下径及前后径测值较小,C3、C7测值较大,而椎间孔内神经根的径线由上至下逐渐增大;神经根与脊髓在水平面上向前的前倾角各节段变化不大,在15°～19°,而与冠状面上向下的下倾角从C3到C7逐渐变小;颈神经后根根丝间存在着广泛的吻合支。结论椎间孔入口关节突内侧0.6cm的范围内最狭窄,切除此范围的关节突关节,既达到了对神经根减压的效果,又保留了脊柱的稳定性;颈神经存在广泛的吻合支,颈椎病的表现和神经定位不能完全相对应;C4、C5、C6椎间孔的上下径及前后径较小,而其神经根的径线较大,C4、C5、C6神经根最易受压。更多还原

【Abstract】 Objective To study the course of different cervical nerve segments and their related intervertebral foramen’s size so as to increase safety and decrease complications in microinvasive surgery for cervical syndrome. Methods Fifteen human cervical specimens (30 sides) were anatomically observed for the course, branches and distribution of cervical nerves. Results The diameter of intervertebral foramen ranges from 0.54 to 0.65 cm, and increases gradually from top to bottom. The vertical diameter and anteroposterior diameter between C4, C5 and C6 vertebrae are smaller, and those between C3 and C7 are larger, but the diameter line of nerve root in intervertebral foramen from up to down gradually increases. The anteversion angle between nerve root and spine cord on horizontal plane is from 15° to 19°, within a small variation, while the declination angle on coronal plane gradually decreases from C3 to C7. There exist plenty of anastomosis branches among the cervical dorsal rami. Conclusion In the range of 0.6 cm around articular process at the entrance of intervertebral foramen, it is the narrowest part, the removal of which may alleviate the pressure on nerve root and benefit spinal stability. Because of the general existence of anastomosis branches of cervical nerve, the symptoms of cervical syndrome are not completely consistent to innervation. The intervertebral foramen between C4, C5, C6 is relatively small and the diameter line of nerve root is comparatively large, so the nerve root at C4, C5, C6 is most likely to be pressed.更多还原