Ebraheim N A, Lu J, Yang H, Heck B E, Yeasting R A
Departments of Orthopaedic Surgery, Medical College of Ohio, Toledo 43614, USA.
Spine (Phila Pa 1976). 2000 Jul 1;25(13):1603-6. doi: 10.1097/00007632-200007010-00002.
Anatomic dissection and measurements of the cervical sympathetic trunk relative to the medial border of the longus colli muscle and lateral angulation of the sympathetic trunk relative to the midline on both sides were performed.
To determine the course and location of the sympathetic trunk quantitatively and relate this to the vulnerability of the sympathetic trunk during the anterior approach to the lower cervical spine.
The sympathetic trunk is sometimes damaged during the anterior approach to lower cervical spine, resulting in Horner's syndrome with its associated ptosis, meiosis, and anhydrosis. No quantitative regional anatomy describing the course and location of the sympathetic trunk and its relation to the longus colli muscle is available in the literature.
In this study, 28 adult cadavers were used for dissection and measurements of the sympathetic trunk. The distance between the sympathetic trunk and the medial borders of the longus colli muscle at C6 and the angle of the sympathetic trunk with respect to the midline were determined bilaterally. The distance between the medial borders of the longus colli muscle from C3 to C6 and the angle between the medial borders of the longus colli muscle also were measured.
The sympathetic trunk runs in a superior and lateral direction, with an average angle of 10.4 +/- 3.8 degrees relative to the midline. The average distance between the sympathetic trunk and the medial border of the longus colli muscle is 10.6 +/- 2.6 mm. The average diameter of the sympathetic trunk at C6 is 2.7 +/- 0.6 mm. The length and width of the middle cervical ganglion were 9.7 +/- 2.1 mm and 5.2 +/- 1.3 mm, respectively. The distance between the medial borders of the longus colli muscle was 7.9 +/- 2.2 mm at C3, 10.1 +/- 3.1 mm at C4, 12.3 +/- 3.1 mm at C5, and 13.8 +/- 2.2 mm at C6, and the angle between the medial borders of the longus colli muscle was 12.5 +/- 4. 7 degrees.
The sympathetic trunk may be more vulnerable to damage during anterior lower cervical spine procedures because it is situated closer to the medial border of the the longus colli muscle at C6 than at C3. The longus colli muscles diverge laterally, whereas the sympathetic trunks converge medially at C6. As the transverse foramen or uncovertebral joint is exposed with dissection or transverse severance of the longus colli muscle at the lower cervical levels, the sympathetic trunk should be identified and protected.
对颈交感干相对于颈长肌内侧缘进行解剖和测量，并测量两侧交感干相对于中线的外侧成角情况。
定量确定交感干的走行和位置，并将其与下颈椎前路手术中交感干的易损性相关联。
在下颈椎前路手术中，交感干有时会受损，导致霍纳综合征及其相关的上睑下垂、瞳孔缩小和无汗。文献中尚无描述交感干走行和位置及其与颈长肌关系的定量局部解剖学研究。
本研究使用28具成年尸体进行交感干的解剖和测量。双侧确定颈6水平交感干与颈长肌内侧缘之间的距离以及交感干相对于中线的角度。还测量了颈3至颈6水平颈长肌内侧缘之间的距离以及颈长肌内侧缘之间的夹角。
交感干向上外侧走行，相对于中线的平均角度为10.4±3.8度。交感干与颈长肌内侧缘之间的平均距离为10.6±2.6毫米。颈6水平交感干的平均直径为2.7±0.6毫米。颈中神经节的长度和宽度分别为9.7±2.1毫米和5.2±1.3毫米。颈3水平颈长肌内侧缘之间的距离为7.9±2.2毫米，颈4为10.1±3.1毫米，颈5为12.3±3.1毫米，颈6为13.8±2.2毫米，颈长肌内侧缘之间的夹角为12.5±4.7度。
在下颈椎前路手术中，交感干可能更容易受损，因为在颈6水平它比在颈3水平更靠近颈长肌内侧缘。颈长肌向外侧分开，而交感干在颈6水平向内侧汇聚。在下颈椎水平，当通过解剖或横断颈长肌暴露横突孔或钩椎关节时，应识别并保护交感干。
