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上颈椎的前外侧入路:病例报告及手术技术

Anterolateral approach to the upper cervical spine: Case report and operative technique.

作者信息

Song Yohan, Tharin Suzanne, Divi Vasu, Prolo Laura M, Sirjani Davud B

机构信息

Department of Otolaryngology/Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.

Department of Neurological Surgery, Stanford University School of Medicine, Stanford, California.

出版信息

Head Neck. 2015 Sep;37(9):E115-9. doi: 10.1002/hed.23951. Epub 2015 May 26.

Abstract

BACKGROUND

Transcervical approaches to the upper cervical spine are challenging because several upper anterior neurovascular structures need to be displaced to provide access. Although various techniques have been described, the anterolateral approach is one of the safest and most effective methods available to access the anterior C2-C3 disc space. Despite the approach's efficacy, however, it can cause postoperative complications because of, at least partly, the inter-surgeon differences in the methods by which the larynx and hypopharynx are displaced medially.

METHODS AND RESULTS

We present a case report of a patient treated with a modified anterolateral approach to C2-C3. The approach provided excellent visualization while protecting vital structures. The patient recovered without any postoperative dysphagia or other surgical complications.

CONCLUSION

The anterolateral approach to C2-C3 described herein safely protects the contents of the submandibular triangle while providing a wide exposure for direct access to the C2-C3 disc space.

摘要

背景

经颈入路上颈椎手术具有挑战性,因为需要移位几个上前神经血管结构以提供手术入路。尽管已描述了各种技术,但前外侧入路是可用于显露C2-C3椎间盘间隙的最安全、最有效的方法之一。然而,尽管该入路有效,但至少部分由于外科医生在将喉和下咽向内侧移位的方法上存在差异,它可能导致术后并发症。

方法与结果

我们报告一例采用改良C2-C3前外侧入路治疗的患者。该入路在保护重要结构的同时提供了极佳的视野。患者恢复良好,无术后吞咽困难或其他手术并发症。

结论

本文所述的C2-C3前外侧入路在安全保护下颌下三角内容物的同时,提供了广阔的视野,可直接显露C2-C3椎间盘间隙。

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