神经根型颈椎病解剖因素探讨

目的　探讨颈神经在椎间孔及脊神经沟处受嵌压的解剖学因素。方法　取 6 0具成尸 (男 2 8,女32 ) ,对颈椎间孔及其脊神经根的前后径、上下径进行观测 ,统计出颈神经根前后径、上下径分别大于或等于椎间孔的前后径、上下径的出现率 ;同时观测脊神经沟外口宽度及其沟内段脊神经前支横径 ,统计出脊神经前支横径大于或等于脊神经外口宽度的出现率。结果　①颈神经根在椎间孔处可造成嵌压 ,其出现率为 2 4 6 % ,其中女性为 35 2 %明显高于男性的 12 5 % (P <0 0 1) ;②颈神经前支在颈椎脊神经沟处可造成嵌压 ,其出现率为 6 3% ,其中男性为 8 9%明显高于女性的 2 9% (P <0 0 1)。结论　颈神经受累不仅与椎间孔狭窄有关 ,而且与脊神经根外径和周围软组织损伤有关 ,临床诊断颈椎病应采用X线片与临床表现相结合方可减少漏诊率。

Anatomical Study on the Cervical Spondylosis with the Spinal Nerve Roots Type

Objective To study the anatomical factors causing spinal nerves stuck in the cervical intervertebral foramen and the spinal nervous sulcus. Method The sagittal width and height of the intervertebral foramen and its spinal nerve roots as well as the width of the lateral opening of the spinal nervous sulcus and its outside diameters of spinal nerves were measured on 60 cases (male28, female 32) adult cadavers (total 120 sides). The percentage of the outside diameter of the spinal nerve larger than or equal to the corresponding intervertebral foramen and spinal nervous sulcus were measured.Results ①The percentage of the outside diameter of the spinal nerve roots larger than or equal to the corresponding intervertebral foramen was 24.6% in all cases, with the female (35.2%) significantly more than the male (12.5%) (P<0 01).②The ratios of spinal nerve to spinal nervous sulcus was 6.3% in all cases, with the male (8.9%) significantly more than the female (3.9%) (P<0 01). Conclusion It is suggested that lesions of the spinal nerve roots or their anterior branches were not only related closely to the stenosis of intervertebral foramen and spinal nervous sulcus, but also related to the outside diameter of the spinal nerve roots and the damage of soft tissue in spinal nervous canal. It is very important that the combination of X ray with the clinical manifestation was used in the diagnosis and the treatment of various types of cervical spondylosis.