下颈椎椎动脉孔及其毗邻的解剖学和影像学观测

目的：为下颈椎前路手术预防椎动脉损伤提供解剖学数据。方法：(1)取20具尸体的C3～7段作为解剖标本，作两侧椎动脉孔内缘间距、椎体横、矢径、椎动脉孔内缘和椎弓根内缘间距、椎动脉孔内缘和椎体外缘间距、 椎动脉孔内缘和钩突关节内外缘间距、椎动脉孔前后缘与椎体前后缘的垂直距离、 椎动脉孔矢径的测量。(2)选30例已确诊为颈椎病患者和50例正常人作为检测对象，用CT测量上述数据。 结果： (1) C_3～7两侧横突孔内缘间距、椎体横径、椎体矢径、C_3～6椎动脉孔矢径逐渐增大。(2) 钩突内缘与椎动脉孔内缘间距在6 mm之内, C_3～6椎体外缘与椎动脉孔内缘间距不超过3 mm。(3) C_3～6 横突孔矢径和椎体矢径比值恒定(30.32%～31.86%), C_3～5 椎动脉孔前缘与椎体前缘距离逐渐减小，C_3～5椎动脉孔后缘与椎体后缘距离逐渐增加。结论：本文的测量数值与不同个体的椎动脉资料相结合，为预防椎动脉损伤提供了解剖学依据。

Anatomy and imageology of the vertebral artery foramen and its adjacency of the lower cervical vertebrae

        Objective: To provide anatomic basis of the vertebral artery foramen for protecting vertebral artery during the lower cervical vertebrae operation. Methods:（1）Anatomic parameters of 20 C3～7 cervical specimens of human cadavers were measured and analyzed, including the interforaminal distance, the width of vertebral body and pedicle, the distance from medial border of transverse foramen to external border of vertebral body, from medial border of transverse foramen to internal and external borders of uncinate process, from posterior border of transverse foramen to posterior border of vertebrae, from anterior border of transverse foramen to anterior border of vertebrae, and the anteroposterior diameter of transverse foramen and vertebrae. (2)Under CT, above parameters were measured for 30 CSM patients and 50 normal people. Results:(1) From C3 to C7, the interforaminal distance, the width of vertebral body, sagittal diameter of vertebrae, sagittal diameter of transverse foramen gradually increased. (2)The distance between medial border of uncinate process and medial border of transverse foramen was within 6mm, and the distance from medial border of transverse foramen to external border of vertebrae in C3～6 was within 3mm. (3)From C3 to C6, the ratio of sagittal diameter of transverse foramen to sagittal diameter of vertebrae was constant(30.32%～31.86%), however, the distance from anterior border of transverse foramen to anterior border of vertebrae gradually decreased, whereas, the distance from posterior border of transverse foramen to posterior border of vertebrae gradually increased. Conclusions: Our anatomic study provides useful information for the prevention of vertebral artery injury during operation.