枢椎横突孔观测及其临床意义

目的 :探讨枢椎横突孔结构在转头引起寰枢段椎动脉狭窄或闭塞的临床解剖学意义。方法 :观测 10 0例枢椎横突孔上口的开口方向、孔径、上口与下口之间的成角、以及横突孔水平距离。结果 :两侧枢椎横突孔孔径相差不大 ,最大径为 6.1± 0 .7mm,最小径 5.4± 0 .6mm。两侧横突孔上口开口方向明显不对称 ,上口与下口之间的角度为 12 7± 2 2°,左侧较右侧明显 ,甚至形成直角或锐角 ,且左侧横突孔水平距离较长 ,说明椎动脉在孔内弯曲或扭曲。结论 :枢椎横突孔的结构对其中椎动脉起着一种牵系作用 ,在寰枢椎不稳时易导致椎动脉的损害     

远外侧经枕髁手术入路防止椎动脉损伤的应用解剖

目的:为远外侧经枕髁入路手术保护椎动提供较详细的解剖资料。方法:应用20具(40侧)成人尸头湿标本进行显微解剖研究。结果:寰椎横突、第2颈神经前支、肩胛提肌、椎动脉周围静脉丛、头外侧直肌为确认第2、3段椎动脉的重要标志。寰、枢椎横突孔间距左侧为(15.3±1.6)mm,右侧(15.8±2.2)mm;枕骨大孔后缘中点距椎动脉入硬脑膜口处左侧(21.6±2.0)mm,右侧(21.5±2.0)mm;椎动脉于寰椎后弓上方向后呈弓形弯曲,其外侧跨度左侧(17.9±3.2)mm,右侧(17.7±3.2)mm;内侧跨度左侧(9.8±2.5)mm,右侧(9.8±2.2)mm;向后距椎板高左侧(7.4±2.3)mm,右侧(6.3±3.3)mm。结论:熟悉椎动脉第2、3、4段的毗邻关系及解剖标志,对保护椎动脉、安全地施行远外侧经枕髁入路手术至关重要。     

儿童寰枢椎后路椎弓根螺钉固定的解剖与影像学研究

目的：探讨儿童寰枢椎后路置入直径为3．5mm的椎弓根螺钉的可行性。方法：（1）儿童脑死亡尸体标本10具，年龄6～8岁，测量寰椎椎弓根高度、宽度，寰椎侧块中部高度、宽度，椎动脉沟下方的寰椎后弓的宽度，椎动脉沟下方的寰椎后弓的外侧1／3、内侧1／3高度、枢椎椎弓根（横突孔）外缘、内缘高度，枢椎椎弓根（横突孔）上缘、中缘、下缘宽度；（2）对20例6～8儿童寰枢椎进行CT平扫，利用CT工作站测量寰枢椎横断面上寰椎椎弓根长度、宽度，枢椎椎弓根长度、宽度；寰枢椎椎弓根纵轴与正中矢状面的角度。结果：标本组寰椎椎弓根高度和宽度分别为（5．26±0．44）mm和（6．26±0．75）mm，寰椎椎动脉沟下方的寰椎后弓的外侧1／3高度为（4．07±0．24）mm，枢椎椎弓根外缘高度和内缘高度分别为（6．86±0．48）mm和（6．67±0．49）mm，上缘宽度、中缘宽度和下缘宽度分别为（6．63±0．61）mm、（5．41±0．39）mm、（3．71±0．30）mm。CT组寰椎高度为（5．47_＋0．34）mm、宽度为（6．63＋0．54）mm；枢椎高度为（6．59±0．51）mm、宽度为（5．13±0．42）mm；寰枢椎椎弓根纵轴与正中矢状面的角度分别为（9．60±1．32）°、（27．80±2．22）°。结论：6～8岁儿童寰枢椎椎弓根容纳直径为3.5mm的螺钉是可行的。     

椎动脉近段的应用解剖学研究

目的　为椎动脉近段的重建术提供解剖学基础。方法　在 2 4具 4 8侧经防腐处理的新鲜尸体标本上观察椎动脉近段的起点、分支、走行情况 ,测量椎动脉近段两端管腔外径、长度。结果　椎动脉近段的起点外径左侧为 (4 5 2± 0 79)mm ;末端外径左侧为 (4 1 2± 0 71 )mm ,右侧为 (3 90± 0 82 )mm ;全长左侧为 (33 7± 8 3)mm ,右侧为 (2 7 75± 5 1 )mm。结论　椎动脉近段的观察与测量结果对椎动脉近段重建提供重要参考价值。     

寰椎侧块的测量及其临床意义

目的 :为临床寰椎侧块螺钉内固定手术提供解剖学依据。方法 :3 0具新鲜尸体寰椎标本 ,依次测量寰椎侧块的宽度、厚度、高度、寰枢关节面及其倾斜角度。结果 :寰椎侧块的宽度 ( 15 .47± 1.19)mm ,厚度 ( 17.2 1± 0 .93 )mm ,高度 ( 14 .0 9± 1.92 )mm ,侧块外侧壁到中线的距离 ( 2 2 .0 6± 1.2 6)mm ,寰枢关节面的横径 ( 17.90± 1.18)mm ,寰枢关节面的纵径 ( 15 .63± 1.0 4)mm ,寰枢关节在冠状面上的角度 ( 3 4.5 7±3 .77)°。结论 :寰椎侧块较为宽大 ,在理论上有寰椎侧块螺钉固定的足够空间。     

颅后窝外侧入路术的应用解剖

目的 :为颅后窝手术入路提供避免损伤血管神经等的解剖学依据。方法 :解剖测量 16例成人头颅标本。结果 :乳突尖至茎突尖、寰椎横突外侧端和茎突尖至寰椎横突外侧端三者之间的距离分别为(3 0 .67± 6.3 8)mm ,(2 4.15± 4.46)mm和 (15 .2 0± 3 .5 0 )mm。乳突尖至面神经、颈静脉孔的外缘和颈动脉管外口的外缘、枕骨髁外侧缘中点的距离分别为 (10 .11± 3 .0 2 )mm ,(2 2 .93± 3 .5 9)mm ,(3 0 .40±3 .3 7)mm和 (3 1.43± 3 .11)mm。乳突尖至Ⅸ、Ⅹ、Ⅺ和Ⅻ对脑神经出颅处的距离分别为 (2 6.13± 5 .49)mm ,(2 4.2 7± 4.11)mm ,(2 1.17± 4.3 4)mm和 (2 4.64± 4.64 )mm。结论 :在颅后窝外侧入路的手术中 ,应重视乳突至茎突、寰椎横突外侧端和茎突至C1横突外侧端的间距 ,以及乳突至颈内静、动脉 ,Ⅸ、Ⅹ、Ⅺ和Ⅻ对脑神经的位置和距离等能有效地在手术时保护它们。     

第5腰椎横突肥大综合征的解剖学研究

目的 为第5腰椎横突肥大综合征提供解剖学基础.方法 用第5腰椎、骶骨各390块,测量第5腰椎横突、椎间孔的上下径和前后径.结果 第5腰椎横突正常上下径为13.3±2.6mm,前后径12.4±2.5mm正常椎间孔前后、上下径.第5腰椎肥大的横突上下径为20.9±2.4mm,前后径30.9±3.3mm.第5腰椎横突肥大L5～S1椎间孔的前孔,左侧:上下径11.5±4.3mm,前后径10.5±2.7mm;右侧:上下径10.2±4.5mm,前后径9.6±3.0mm.结论 第5腰椎横突肥大,可引起L5～S1椎间孔的前孔狭窄,累及第5腰神经,为腰腿痛的原因之一.     

椎动脉分段的临床解剖学观点

目前在一般的解剖学教科书上绝大多数认为椎动脉按行程可分为四段:第一段,椎动脉发出至椎动脉进入第六颈椎横突孔;第二段,椎动脉走行于上六位颈椎的横突孔中;第三段,椎动脉出寰椎横突孔后走行于寰椎动脉沟内;第四段,椎动脉通过枕骨大孔,进入硬脊膜后沿变为颅内段。这四段亦可称为颈部、椎骨部、枕部和颅内部。 而影像学上椎动脉的分段却与之相差甚远:V1(横突孔段)指椎动脉穿经枢椎横突孔后以前的一段椎动脉,该段呈垂直走行;V2(横段)指椎动脉穿出枢椎横突孔之后横行向外侧的一段椎动脉;V3(寰椎段)指从椎     

寰椎的测量及临床应用意义

目的测量国人寰椎骨,为寰椎螺钉设计和内固定提供解剖学依据。方法用游标卡尺和量角器测量55例干燥的成人寰椎标本的相关参数,包括寰椎侧块的长度、侧块中间宽度、侧块中间厚度、侧块外侧缘中点高度、侧块内侧缘中点高度、寰椎侧块的内倾角、寰椎侧块的上倾角、侧块后下缘的宽度和高度、寰椎前弓与侧块交接处高度和厚度;横突孔的前后径和左右径;椎动脉沟宽度和高度;椎动脉沟底骨质最薄处宽度和高度等等,并进行统计学分析。结果寰椎侧块长（23．29±1．47）mm,侧块中间宽（11．13±1．17）mm,侧块中间厚（13．33±1．40）mm,侧块外侧缘中点高（19．18±1．61）mm,侧块内侧缘中点高（10．45士1．46）mm;寰椎侧块的内倾角（19．95±3．32）。寰椎侧块的上倾角（24．53±2．31）。;侧块后下缘宽（9．64±0．94）mm,侧块后下缘高（4．275=0．63）mm;前弓与侧块交接处高（11．05±1．12）mm,前弓与侧块交接处厚（4．82±0．65）mm;横突孔的前后径（7．30±0．89）mm,横突孔的左右径（5．90±0．78）mm椎动脉沟宽（8．40±0．58）mm,椎动脉沟高（6．38±0．79）mm椎动脉沟底骨质最薄处宽（7．25±1．27）mm,椎动脉沟底骨质最薄处高（4．16±0．83）mm。以上数据左、右侧比较差异无显著性（P〉0．05）。结论测得55例寰椎骨数据,寰椎侧块和寰椎椎弓根具备实行内固定的条件。     

寰枢椎穿刺入路的应用解剖

目的 :为临床寰枢椎穿刺入路提供解剖学依据。方法 :对 2 0例上颈段脊柱标本进行了徒手解剖和横切面解剖观察。结果 :①经咽入路至寰椎前弓和枢椎齿突的穿刺点为与腭垂相对的咽后壁正中线上 ,定为A点 ,向后水平进针 ,深度分别为 ( 0 .95± 0 .0 4)cm和 ( 1.5 2± 0 .0 8)cm。经咽后壁至寰椎侧块的穿刺点为A点旁开 1.5cm处 ,深度为 ( 1.2 3± 0 .0 5 )cm。至枢椎体的穿刺点为A点下移 2 .0cm处 ,即B点 ,深度为 ( 1.13± 0 .0 6)cm。至枢椎侧块的穿刺点为B点旁开 1.8cm ,深度为 ( 1.3 6± 0 .0 6)cm。②经颈后外侧入路至寰椎前弓、寰椎侧块和枢椎齿突的穿刺点为枕外隆突至乳突尖连线的中外 1/ 3交界处 ,为C点 ,深度和角度分别为 ( 6.3 2± 0 .97)cm和 66.0 0°± 1.62°、( 4 .2 3± 0 .3 0 )cm和 63 .0 0°± 1.77°、( 5 .85±0 .5 1)cm和 71.0 0°± 1.83°。至枢椎体及侧块的穿刺点为C点向下 2 .0cm处 ,称为D点 ,深度和角度分别为 ( 4 .41± 0 .2 9)cm和 65 .0 0°± 1.68°、( 5 .46± 0 .48)cm和 70 .0 0°± 1.78°。③对穿刺入路的层次结构做了详尽的描述。结论 :上述两种穿刺入路有关测量结果可为术中准确定位有关结构提供参考依据 ,并有效避免损伤颈部大血管和神经。     

Anatomy and prevalence of atlas vertebrae bridges in a Kenyan population: An osteological study

Atlas bridges are bony outgrowths over the third segment of the vertebral artery. They may exist as incipient, incomplete, or complete bridges, converting the groove into a deep sulcus, incomplete, or complete foramen respectively. These bridges and their associated foramina display bilateral and sex differences in their prevalence and type. Occurrence of these bridges may predispose to vertebrobasilar insufficiency and Barre–Lieou syndrome. The coexistence of lateral and posterior bridges as well as side predilection is not clear in either sex. Their relative occurrence may also point to some evolutionary patterns. We studied the prevalence, side predilection, coexistence, and anatomical features of atlas bridges using 102 dry atlases (49 males and 53 females) obtained from the osteology department of the National Museums of Kenya. Complete posterior bridges occurred in 14.7% and 13.7% on the right and left sides, respectively. A lateral bridge was found in 3.9% of cases on the right side only. There was positive correlation in the coexistence of the bridges. A retrotransverse foramen was found in 13% of cases. This study has found that posterior and lateral atlas bridges occur in association especially on the right side. Complete bridges were more prevalent in females and were more often present on the right side. This pattern seems to mirror the sexual predilection of vertebral artery compression syndromes. Gender roles may have an influence on the occurrence of these bridges and therefore the syndromes as well. Clin. Anat. 23:649–653, 2010. © 2010 Wiley‐Liss, Inc.     

Microsurgical anatomy of the foramen of Luschka in the cerebellopontine angle,and its vascular supply

Cerebellopontine angle and vascular supply of adjacent brainstem and cerebellum are susceptible to compression and eventual damage by tumors. Delicate and complicated neurosurgical operations in the cerebellopontine angles of the brainstem, where lateral recesses of fourth ventricle empty, are abundant especially operations in which foramina of Luschka are used as possible access to the floor of the fourth ventricle. So awareness and knowledge of the normal anatomical features of the region is valuable for neurosurgeons. Arteries of 40 human cerebella were injected with colored gelatin to investigate the microsurgical anatomy around the foramen of Luschka in the cerebellopontine angle. Two compartments of the foramen of Luschka were distinguished, choroidal part and the patent part. Seventy-four (92.5%) of foramina were open and only 6 (7.5%) foramina were closed. The mean distance between the foramen of Luschka and the anterior inferior cerebellar artery was 3.90 mm on the left side and 3.89 on the right side. The distance from the posterior inferior cerebellar artery was 7.08 and 5.81 mm to the left and right foramina of Luschka, respectively. In ten cases, tortuous vertebral artery was occupying the left cerebellopontine angle space and the foramen of Luschka.     

Anatomical study of the vertebral artery in japanese adults

The aim of the present study was to examine the vertebral arteries. The origins of the right and left vertebral arteries and their entrance points into the cervical transverse foramen were examined in dissections of 515 Japanese cadavers (303 males, 212 females) at Kurume University School of Medicine from 1990 to 2003. There were 515 right vertebral arteries and 514 left vertebral arteries. The right vertebral artery originated from the right subclavian artery in 514 of 515 arteries and one of the arteries arose from the bifurcation of the brachiocephalic trunk. The mean distance between the origin of the right subclavian artery and the right vertebral artery was 20.9 mm. The left vertebral artery originated from the left subclavian artery in 484 of 514 arteries and the mean distance between the origin of the left subclavian artery and the left vertebral artery was 32.1 mm. The remaining 30 arteries (5.8%) originated from the aortic arch between the left common carotid artery and the left subclavian artery and this frequency is similar to previously published data. There was no right-left difference for the entrance point of the vertebral arteries into the cervical transverse foramen and the 6th cervical vertebra (C6) was the most common entrance point. Seventy-eight percent of our cases had right and left vertebral arteries that originated in the subclavian arteries and entered the cervical transverse foramen at C6. Among the 30 left vertebral arteries that originated from the aortic arch, 20 arteries (66.7%) entered a cervical transverse foramen at a level higher than C6. This frequency was higher than that for the left vertebral artery that originated from the subclavian artery.     

翼腭间隙的横断层解剖及临床意义

目的为翼腭间隙疾病的影像诊断提供解剖学资料。方法选用成年尸体头颈部20例制成连续横断面,观察翼腭间隙及其结构的解剖学关系,利用游标卡尺及求积仪分别测量其长径、宽径和面积。结果翼腭间隙形态多变,在蝶骨体层面较固定,与翼突形态密切相关、经圆孔、蝶骨体、翼突和翼窝层面的面积分别为:(40.40±2.42)mm2(左)、(43.10±2.88)mm2(右);(110.20±3.32)mm2(左)、(115.56±2.52)mm2(右);(93.20±2.76)mm2(左)、(90.82±3.12)mm2(右);(5.48±3.02)mm2(左);(5.26±2.74)mm2(右),两侧翼腭间隙及其结构呈对称性,断面长径、宽径和面积均无显著性差异(P>0.05)。横断面可清晰显示翼腭间隙前、后、内侧和外侧壁上的结构及圆孔、翼管、蝶腭孔、翼上颌裂和眶下裂等自然通道。结论翼腭间隙的横断层解剖对翼腭间隙疾病的影像诊断具有重要临床意义。     

Topographic variations of the optic chiasm and the foramen diaphragma sellae

Pituitary adenomas can expand upward through the foramen diaphragma sellae (FDS), compress the visual pathways on the suprasellar region, and cause diverse visual defects. However, the relationship between the FDS and the visual pathway has not been thoroughly clarified. This study was thus performed to determine the topographic relationship between these two structures. One hundred heads of adult cadavers were examined in this study. The FDS was classified into five types (Ia, Ib, Ic, II, and III) according to its location relative to the four parts of suprasellar region of the visual pathways. The midpoint of the optic chiasm (OC) was located on the midline passing through the crista galli in 70% of cases, but to the left and right sides of the midline in 9 and 21% of cases, respectively. The FDS was completely covered by OC in 30% of the cases, but it was partly seen superiorly in 70%. The pituitary infundibulum passed mainly through the center middle or posterior middle part of nine partitions of the FDS. The horizontal and vertical diameters of the foramen were 7.9 ± 2.0 and 7.6 ± 1.9 mm, respectively. The length of the optic nerve was 9.7 ± 1.9 mm on the left side and 9.5 ± 1.9 mm on the right side. The angle between the optic nerve and the midline was 34.5° ± 5.7° on the left side and 36.0° ± 6.3° on the right side. The results of this study are expected to further the current knowledge of the topographic anatomy on suprasellar structures.     

内镜引导下经后路上颈椎螺钉内固定的应用解剖

目的探讨内镜引导下经后路上颈椎螺钉内固定的应用解剖,为临床经后路C2/3椎弓根螺钉固定术提供解剖学资料。方法选用干骨28套(C1-7),对其滋养孔的位置、椎弓根等相关数据进行了观察和测量。结果C2/3的滋养孔距后正中线分别为(17.26±7.36)和(16.05±7.95)mm;椎弓根的长、高、宽(mm)分别为6.18±1.36、8.87±2.22、11.54±3.21和4.95±3.5、7.00±0.97、10.50±4.11;椎弓根的中轴线与正中矢状切面所构成的夹角分别为(43.83±3.09)°和(41.53±3.29)°。结论临床经后路C2/3椎弓根螺钉内固定手术,进螺点可选定在C2/3侧块距其外侧缘5mm、距下关节突下缘8mm处,螺钉进入的延长线与正中矢状切面的夹角应为40°～45°,并向头侧倾斜10°为宜,螺钉的长度为24～30mm,覬为5mm为佳。     

长白猪与成年人房室交点区的解剖学比较

目的 观测家猪房室交点区解剖学特征,为比较解剖学积累资料.方法 采用30例长白猪心脏在新鲜状态下测量房室交点区相关数据,建立几何模型处理数据.10％甲醛固定48 h后,用过氯乙烯—丙酮填充剂灌注左、右冠状动脉及其分支,心大静脉及其属支.解剖并观测房室交点区结构.结果 左、右后房室沟和后室间沟呈“Y”型相交.后房间沟呈弧...     

椎动脉颅内段的解剖学研究及其临床意义

目的 观察椎动脉颅内段的形态特点,为临床提供解剖学依据。方法 在25具经防腐处理的成人尸体标本上,观察椎动脉颅内段的形态特点,测量椎动脉颅内段起、止点的压扁外径及长度。结果 椎动脉颅内段起点压扁外径左侧为5．19±0．33mm,右侧为4．82±0．59mm,止点压扁外径左侧为5．05±0．37mm,右侧为4．66±0．77mm;长度左侧为32．7±1．2mm,右侧为32．7±1．1mm。结论椎动脉颅内段的测量结果对椎动脉颅内段的病变有重要参考价值。