Ding Zihai, Yu Chunjiang, Tian Derun, Li Yunsheng, Yu Chunshui
Center of Orthopedics Trauma, General Hospital of Ji'nan Command, People's Liberation Army, Ji'nan 250031, China.
Zhonghua Wai Ke Za Zhi. 2002 Jun;40(6):427-9.
To study the shape and the structures in the craniocervical junction region (CCJR) and the safety of far lateral approach.
Ten cadaveric heads and 20 skull-base specimens were fixed with 10% formalin, and 4 of the 10 cadaveric heads were sectioned in different plane with the aid of operative microscope. The shape and relation of structures in the CCJR were observed.
The third segment of the vertebral artery(VA) was 21.6(15.3 31.9) mm. An incomplete bony canal was found to be 15% and complete bony canal surrounding the VA to be 5% on the VA groove. The distance of the left and right VA was 14.3a(c)(9.8 15.2) mm on the entry into the dura. The length of the occipital condyle was 26.8(25.1 28.2) mm, with the thickness of its anterior, middle and posterior one-third part was 9.9(9.6 10.6) mm, 11.2(9.2 13.1) mm and 8.6 (8.3 9.0) mm respectively. The distance between the posterior pole of the occipital condyle and the intracranial orifice of the hypoglossal canal was 9.9(8.6 11.4) mm, and between the posterior pole and the extracranial orifice was 16.1(13.5 17.1) mm. The transverse process of the atlas was the most important bony landmark for the approach.
Knowing the shape and relationship of the VA and occipital condyle in the CCJR is helpful in preserving the important structures in far lateral approach to target region.
研究颅颈交界区（CCJR）的形态和结构以及远外侧入路的安全性。
用10%福尔马林固定10个尸体头部和20个颅底标本，10个尸体头部中的4个在手术显微镜辅助下沿不同平面切开，观察CCJR中结构的形态及关系。
椎动脉（VA）第三段长21.6（15.3～31.9）mm，VA沟处发现15%的骨管不完整，5%的骨管完整包绕VA。硬膜入口处左右VA间距为14.3（9.8～15.2）mm。枕髁长26.8（25.1～28.2）mm，其前三分之一、中三分之一和后三分之一厚度分别为9.9（9.6～10.6）mm、11.2（9.2～13.1）mm和8.6（8.3～9.0）mm。枕髁后极与舌下神经管颅内口间距为9.9（8.6～11.4）mm，与颅外口间距为16.1（13.5～17.1）mm。寰椎横突是该入路最重要的骨性标志。
了解CCJR中VA和枕髁的形态及关系有助于在远外侧入路至靶区时保护重要结构。
