上胸椎手术前方入路研究进展

上胸椎主要是指C7~T4,因其位于前胸部,部位深在,前方有胸骨、肋骨及锁骨阻挡,深部结构比较复杂,所以上胸椎前方手术暴露较为困难,技术要求较高。据报道,约10%~15%的脊柱肿瘤、9%的外伤骨折脱位位于上胸椎,此外后纵韧带钙化、椎间盘突出等退行性病变（约0.3%）及结核等也见于上胸椎。目前虽已有较多可供选择的手术途径如后路手术、前后联合手术等,前方入路手术直视下行病椎切除、直接减压,解除脊髓神经的前方压迫,且前路手术不需要破坏后柱结构,不影响后柱的稳定性,目前已广泛应用于临床。

Research Progress on Thoracic Surgery Anterior Approach

Upper thoracic vertebra refers to the upper thoracic spine C7-T4, which is located in the anterior chest, the front of the sternum, ribs and collarbone block, deep structure is more Complex, so the front of the upper thoracic surgical exposure is more difficult. According to reports, approximately 10% to 15% of spinal tumors,9% of trauma fracture and dislocation is located in the upper thoracic spine. Although there have been more choices of surgical approach, such as posterior surgery before and after joint surgery, anterior approach surgery straight down the vertebral resection, direct decompression, lifting the front of the oppression of the spinal cord, and the anterior surgery is not required the destruction after column ; structure does not affect the stability of the posterior column, and it has been widely used in clinic.