颈椎胸段前路微创入路：尸体研究。
Mini-open anterior approach to the cervicothoracic junction: a cadaveric study.
机构信息
Department of Orthopedic Surgery, Second Affiliated Hospital of Wenzhou Medical College, 109 Xueyuan Road, Wenzhou, China.
出版信息
Eur Spine J. 2013 Jul;22(7):1533-8. doi: 10.1007/s00586-013-2766-9. Epub 2013 Apr 8.
PURPOSE
To investigate the feasibility of mini-open anterior approach to the cervicothoracic junction (CTJ) in cadaveric specimens.
METHODS
Four adult fresh-frozen cadaveric specimens were used for this study. On the cadaveric specimen, an osteotomy window was made in manubrium sterni to remove the bony obstacle. To bypass the vital vascular and neural structures over the operative field, we used the surgical corridor which was located medially by the brachiocephalic artery and laterally by the right brachiocephalic vein, or in combination with another surgical corridor between the ascending aorta and the superior vena cava. And we used a special self-retaining retractor system and an endoscope to facilitate the procedures.
RESULTS
Surgical procedures performed on the four fresh-frozen cadaveric specimens to expose the CTJ through mini-open anterior approach were successful. The anterior surface of C6-T5 could be exposed, allowing complete decompression and application of locking plate and screws. The most caudal accessible vertebral body was T5 vertebral body in our study.
CONCLUSION
It is feasible to expose the CTJ through this mini-open anterior approach.
目的
探讨在尸体标本中经微型前外侧入路显露颈胸交界区（CTJ）的可行性。
方法
本研究使用了 4 具成人新鲜冷冻尸体标本。在尸体标本上，于胸骨柄处切开一个骨窗以去除骨性阻挡。为了避开手术区域上方的重要血管和神经结构，我们使用了位于头臂动脉内侧和右头臂静脉外侧的手术通道，或者结合升主动脉和上腔静脉之间的另一个手术通道。我们使用了特殊的自固定牵开器系统和内窥镜来辅助手术。
结果
通过微型前外侧入路在 4 具新鲜冷冻尸体标本上成功完成了显露 CTJ 的手术。可以显露 C6-T5 的前表面，从而实现完全减压并应用锁定钢板和螺钉。在我们的研究中，可触及的最尾端椎体为 T5 椎体。
结论
通过这种微型前外侧入路显露 CTJ 是可行的。
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