颈脊神经后内侧支卡压的解剖及其临床意义

目的为临床诊治颈神经后内侧支卡压提供解剖学基础。方法对10具（20侧）成人尸体头颈标本颈脊神经后内侧支易受卡压的部位进行解剖学观测。结果（1）C2颈脊神经后内侧浅支（枕大神经）易受卡压处分别位于该神经走行于头下斜肌与枢椎椎弓板之间段、穿过头半棘肌段和穿上项线骨纤维孔处。（2）C3-5脊神经后内侧浅支（第三枕神经）易受卡压处分别位于该神经穿行头半棘肌和穿头夹肌段。C3颈脊神经后内侧深支即头夹肌支,该神经穿过头半棘肌处。（3）C3-8后内侧支穿颈脊神经后支骨纤维管。结论颈神经后内侧支穿行的骨纤维管、项部肌肉、项部肌肉的腱性组织是造成颈脊神经后内侧支卡压的解剖学基础。

Applied anatomy of the medial branch of cervical dorsal rami nerve and its clinical significance

Objective To provide anatomic basis for the diagnosis and treatment of the dorsal rami of cervical nerve.Methods The compression place of the medial branch of cervical dorsal rami nerve were observed and measured on 10 adult's embalmed cadavers(20 sides).Results(1)The compression place of the superficial branch of the medial branch of C2 dorsal rami nerve(the great occipital nerve)were the positions where the nerve passed between the obliguus capitis inferior muscle and lamina of vertebral capitis muscle and passed through the fibrous aperture near the superior aperture near the superior nuchal line.(2)The compression place of the branch of the medial branch of C3-5 dorsal rami nerve were the positions where the nerves passed through the semispinalis neck muscle,the semispinalis capitis muscle,the splenius capitis muscle and the tendious fibers of the trapezius muscle.The compression place of the deep branch of the medial branch of C3 dorsal rami nerve were the position where the nerve passed through the semispinalis capitis muscle.(3)The compression place of the medial branch of the C3-8 dorsal rami nerves were the position where the nerves passed through the osseofibrous canal of cervical dorsal rami nerve.Conclusion The osseofibrous canal of the nuchal muscles passed through by the medial branch of the dorsal rami nerves are the anatomic basis of the dorsal and medial branch of the dorsal rami nerves compression syndrome.