刘鑫;孙兆忠;王红艳;李瑞;任佳彬;孙宁;

• 1:滨州医学院附属医院脊柱外科
• 2:滨州医学院附属医院疼痛科

摘要(Abstract)：

[目的]通过应用解剖学与3D-CT方法探讨颈椎后路经皮内镜颈椎间盘切除术(PPECD)行颈椎间孔减压安全有效范围。[方法]5具成人颈部标本,肉眼及显微镜观察C_3-C_7侧块内下端与椎板外下缘交点(O点)及术区毗邻解剖结构。此外,8例颈椎病患者行颈椎CTM,Mimics16.0软件重建颈椎3D-CT图像。经各点建立矢状面:O点、硬脊膜外侧缘、下位椎弓根峡部内侧缘M_((内))及外侧缘M_((外))。横断面测量距离及角度:侧块横径(a),V点与硬脊膜外侧缘(b),O点与M_((内))(c),O点与M_((外))(d),O点与V点(e),O点与硬脊膜外侧缘(f),经O点横断面上、下关节突重叠厚度(i),椎弓根峡部外径(k),椎弓根外倾角(m)。矢状面测量距离:O点与相邻上位M(下)(g)及与下位M(上)(h)。数据行统计学分析。[结果]差异无统计学意义:C_3-C_4~C_7-T_1f[(4.17±1.33)mm~(4.64±1.70)mm]、i[(6.06±2.07)mm~(7.20±1.93)mm](P>0.05);差异有统计学意义:b[(-0.17±1.74)mm~(2.42±1.41)mm]C_3-C_4~C_5-C_6与C_7-T_1(P<0.001);d[(-0.75±1.27)mm~(2.85±1.69)mm]C_3-C_4~C_5-C_6与C_7-T_1、C_3-C_4与C_6-C_7(P<0.001);g[(6.79±1.04)mm~(9.57±1.27)mm]C_3-C_4~C_5-C_6与C_7-T_1(P<0.001);h[(6.79±1.04)mm~(9.57±1.27)mm]C_3-C_4~C_6-C_7与C_7-T_1(P<0.01)。[结论]O点与颈椎间孔关系密切,多贴近下位椎弓根峡部外上缘,与硬脊膜外侧缘距离恒定;C_7-T_1节段形态结构变化大。熟悉该特点,可准确界定减压安全、有效范围,避免或减少重要结构损伤。

关键词(KeyWords)： 颈椎椎间孔;内窥镜;解剖学;3D-CT;安全性

Abstract:

Keywords:

基金项目(Foundation): 山东省自然科学基金资助项目(编号:ZR2017LH021);; 山东省医药卫生科技发展计划资助项目(编号:2014WS0188)

作者(Author): 刘鑫;孙兆忠;王红艳;李瑞;任佳彬;孙宁;

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DOI:

参考文献(References)：

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