Kim Sung-Ho, Lee Jae Hack, Kim Ji Hoon, Chun Kwon Soo, Doh Jae Won, Chang Jae Chil
Department of Neurosurgery, Soonchunhyang University Gumi Hospital, Gumi, Korea.
J Korean Neurosurg Soc. 2012 Oct;52(4):300-5. doi: 10.3340/jkns.2012.52.4.300. Epub 2012 Oct 22.
The purpose of this study is to elucidate the anatomic relationships between the uncinate process and surrounding neurovascular structures to prevent possible complications in anterior cervical surgery.
Twenty-eight formalin-fixed cervical spines were removed from adult cadavers and were studied. The authors investigated the morphometric relationships between the uncinate process, vertebral artery and adjacent nerve roots.
The height of the uncinate process was 5.6-7.5 mm and the width was 5.8-8.0 mm. The angle between the posterior tip of the uncinate process and vertebral artery was 32.2-42.4°. The distance from the upper tip of the uncinate process to the vertebral body immediately above was 2.1-3.3 mm, and this distance was narrowest at the fifth cervical vertebrae. The distance from the posterior tip of the uncinate process to the nerve root was 1.3-2.0 mm. The distance from the uncinate process to the vertebral artery was measured at three different points of the uncinate process : upper-posterior tip, lateral wall and the most antero-medial point of the uncinate process, and the distances were 3.6-6.1 mm, 1.7-2.8 mm, and 4.2-5.7 mm, respectively. The distance from the uncinate process tip to the vertebral artery and the angle between the uncinate process tip and vertebral artery were significantly different between the right and left side.
These data provide guidelines for anterior cervical surgery, and will aid in reducing neurovascular injury during anterior cervical surgery, especially in anterior microforaminotomy.
本研究旨在阐明钩突与周围神经血管结构之间的解剖关系,以预防颈椎前路手术中可能出现的并发症。
从成年尸体上取下28个用福尔马林固定的颈椎并进行研究。作者研究了钩突、椎动脉和相邻神经根之间的形态学关系。
钩突高度为5.6 - 7.5毫米,宽度为5.8 - 8.0毫米。钩突后尖端与椎动脉之间的角度为32.2 - 42.4°。钩突上尖端到紧邻上方椎体的距离为2.1 - 3.3毫米,该距离在第5颈椎处最窄。钩突后尖端到神经根的距离为1.3 - 2.0毫米。在钩突的三个不同点测量钩突到椎动脉的距离:钩突上后尖端、侧壁以及钩突最前内侧点,距离分别为3.6 - 6.1毫米、1.7 - 2.8毫米和4.2 - 5.7毫米。钩突尖端到椎动脉的距离以及钩突尖端与椎动脉之间的角度在左右两侧存在显著差异。
这些数据为颈椎前路手术提供了指导方针,并将有助于减少颈椎前路手术期间的神经血管损伤,尤其是在前路显微椎间孔切开术中。