寰枕关节周围韧带的显微断层解剖

目的：揭示寰枕区的显微断层解剖结构，为临床手术提供准确的解剖学数据。方法：选取8具尸体头颅标本制作颅底组织块，并将这些组织块进行塑化，然后切成连续的切片。染色后在光学显微镜下观察。结果：齿突尖主要为骨密质，齿突中下部主要为骨松质。齿突尖韧带是连接齿突尖与枕骨大孔前缘的细小索状纤维束。覆膜是坚韧的薄膜，从枕骨斜坡下降，在十字韧带的上下纵束之后，与枢椎联系紧密。硬脊膜前方为覆膜，后方为蛛网膜。硬脊膜从斜坡开始与覆膜汇合，并向下移行至枕骨大孔前缘最下方的位置分开然后各自继续向下走行，在齿突的位置和覆膜再次汇合，向下走行至枢椎椎体后分离。在齿突尖水平的位置覆膜与前方的后纵韧带汇合。结论：Barkow韧带可能并不存在，临床手术中不能将其作为识别标志。

Microsectional anatomy of the ligaments around atlantooccipital joint

Objective To reveal the anatomical structure of the atlantooccipital region and to provide accurate anatomical data for clinical operation. Methods Eight cadavers were selected for cranial base tissue blocks, these blocks were plastinated and cut into serial sections. After staining,these sections were examined under an optical microscope. Results The odontoid tip was mainly spongy bone, the lower part of odontoid process was mainly compact bone substance. The apical ligament of dens was a small bundle of cord fibers connecting the apex of dens and the anterior margin of the foramen magnum. The tectorial membrane was a tough film which descends from the occipital slope, after the upper and lower longitudinal fascicles of the cruciate ligament, closely associated with the axis. The front of the spinal dura mater was covered with the tectorial membrane, and the rear was arachnoid. The spinal dura mater joins with the tectorial membrane from the clivus and moves down warded to the lowest part of the anterior margin of the foramen magnum to separate and continue their respective downward course. At the position of the dens, the spinal dura mater joined with the tectorial membrane again and travelled down to C2 vertebral body to separate. The tectorial membrane covered the posterior longitudinal ligament at the level of the odontoid tip. Conclusion The Barkow ligament may not be present and may not be used as a marker during clinical surgery.