| 后路经皮内窥镜下颈椎椎间盘切除术的解剖学研究及临床意义 |
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| 引用本文： | 曹禹文,刘由军,袁佳,江凯燕,徐聪. 后路经皮内窥镜下颈椎椎间盘切除术的解剖学研究及临床意义[J]. 中国临床解剖学杂志, 2020, 38(3): 246-249. DOI: 10.13418/j.issn.1001-165x.2020.03.002 |
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| 作者姓名： | 曹禹文 刘由军 袁佳 江凯燕 徐聪 |
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| 作者单位： | 1.南昌大学第四附属医院骨科， 南昌 330003； 2.南昌大学第四附属医院放射科， 南昌 330003；
3.南昌大学第四临床医学院2015级9班， 南昌 330027
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| 基金项目： | 江西省自然科学基金项目（20151BAB205052） |
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| 摘 要： | 目的探讨后路经皮内窥镜下颈椎椎间盘切除术的安全范围。方法选取20具成人颈椎标本,分别测量C3/C4至C6/C7各节段左右两侧V点与硬脊膜外侧距离、V点与椎动脉水平及垂直距离、小关节面宽度,并进行统计学比较。结果 V点与硬脊膜外侧距离为:左(1.31±0.32)2.46±0.60mm,右(1.29±0.35)2.75±0.45mm,各节段间差别有统计学意义,同一水平左右差别无统计学意义;V点与椎动脉水平距离为:左(2.17±0.42)5.10±0.93mm,右(1.99±0.39)5.00±0.71mm,各节段间差别有统计学意义,同一水平左右差别无统计学意义;V点与椎动脉垂直距离为:左(11.05±1.06)13.47±1.12mm,右(11.33±1.20)13.61±1.01mm,同一水平左右侧差别有统计学意义,节段间比较C3/C4与C4/C5无明显差异,其余节段间差别均有统计学意义;小关节面宽度为:左(10.79±0.93)12.66±0.88mm,右(10.86±0.68)12.54±0.70mm。结论后路经皮内窥镜下颈椎椎间盘切除术的安全范围宜控制在距V点内侧C3/C4至C6/C7各水平1.20~2.00 mm;磨除范围距V点外侧C3/C4至C6/C7各水平超过2.00~5.00 mm时可能到达椎动脉体表投影处,因此需注意此时的手术进入深度宜控制在:C3/C4~C6/C7各节段距V点11.00~14.00 mm。
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| 关 键 词： | 颈椎 后路 应用解剖 内窥镜 V点 |
| 收稿时间： | 2019-07-04 |
Anatomical study of posterior percutaneous endoscopic cervical discectomy and its clinical significance |
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| CAO Yu-wen,LIU You-jun,YUAN Jia,JIANG Kai-yan,XU Cong. Anatomical study of posterior percutaneous endoscopic cervical discectomy and its clinical significance[J]. Chinese Journal of Clinical Anatomy, 2020, 38(3): 246-249. DOI: 10.13418/j.issn.1001-165x.2020.03.002 |
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| Authors: | CAO Yu-wen LIU You-jun YUAN Jia JIANG Kai-yan XU Cong |
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| Affiliation: | 1. Department of Orthopedics ,the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003, Jiangxi Province, China; 2. Department of Radiology, the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003, Jiangxi Province, China; 3. Class 9, Grade 2015, the Fourth Clinical Medical College of Nanchang University , Nanchang 330027, Jiangxi Province, China |
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| Abstract: | Objective To explore the safety operation area of posterior percutaneous endoscopic cervical discectomy. Methods 20 adult cervical spine specimens were taken to measure the distances between the V-point and the lateral spine dura mater, the horizontal and vertical distances between the V-point and the vertebral artery, and the width of the facet joints on the left and right sides of C3/C4 to C6/C7 respectively. Statistical comparison of the data was made. Results The distance between the V point and the lateral spine dura mater was: left (1.31±0.32~2.46±0.60) mm; right (1.29±0.35~2.75±0.45) mm. There was no statistical difference between left and right of the same level, but there was statistical difference among different segments. The horizontal distance between point V and vertebral artery was: left (2.17±0.42~5.10±0.93) mm, right (1.99±0.39~5.00±0.71) mm. There was no statistical difference between left and right of the same level, but there was statistical difference among different segments. The vertical distance between point V and vertebral artery was: left (11.05±1.06~13.47±1.12) mm, right (11.33±1.20~13.61±1.01) mm. There was statistical difference between left and right of the same level，but no statistical difference among the segment of C3/C4 and C4 /C5. The width of facet joints was: left (10.79±0.93~12.66±0.88)mm，right (10.86±0.68~12.54±0.70) mm. Conclusions The safety operation area of posterior percutaneous endoscopic cervical discectomy should be controlled within the range of 1.20~2.00 mm from C3/C4 to C6/C7 on the medial side of the V-point. When the grinding range is more than 2.00~5.00 mm from the C3/C4 to C6/C7 on the lateral side of the V-point, it may reach the body surface projection of vertebral artery. Therefore the depth of surgical entry should be controlled at 11.00~14.00 mm from segments of C3/C4~C6/C7 to the V-point. |
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| Keywords: | Cervical vertebra Posterior Applied anatomy Endoscope V-point |
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