Oh Sung Woon, Singh Ravindra, Adsul Nitin Maruti, Noh Jung Hoon, Park Jun Hwan, Kim Hyeun-Sung, Jang Il-Tae, Oh Seong Hoon
Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Korea.
Department of Ortho-Spine Surgery, Sir Ganga Ram Hospital, Delhi, India.
Neurospine. 2019 Mar;16(1):34-40. doi: 10.14245/ns.1836304.152. Epub 2019 Mar 31.
Vertebral artery injuries during posterior cervical foraminotomy are rare, but can be fatal. Therefore, we investigated the anatomical correlation between the lateral recess and the vertebral artery.
On axial cuts of cervical magnetic resonance imaging from 108 patients, we measured the distance between the vertebral arteries and the medial border of the facet joints. The anatomical vertebro-facet distance (AVFD), surgical vertebro-facet distance (SVFD), and vertebro-facet angle (VFA) were measured.
The mean AVFD values on the right side at the C3-4, C4-5, C5-6, and C6-7 levels showed statistically significant differences. On the right side, the mean SVFD values were equivalent to the AVFD values. The mean values of the VFA on the right side at all levels showed statistically significant differences. For all measurements, the greatest differences were seen between the C5-6 and C6-7 levels, and higher levels were associated with smaller distances from the lateral recess. The mean values of the AVFD on the right and left sides showed statistically significant differences at all levels, and the distances on the left were smaller than those on the right.
The vertebral artery is closer to the lateral recess at higher cervical levels than at lower cervical levels. The largest distances were found at the C5-6 and C6-7 levels, and the left vertebral arteries were closer to the lateral recess than the right vertebral arteries.
颈椎后路椎间孔切开术中椎动脉损伤较为罕见，但可能致命。因此，我们研究了侧隐窝与椎动脉之间的解剖学相关性。
在108例患者的颈椎磁共振成像轴位切片上，我们测量了椎动脉与小关节内侧缘之间的距离。测量了解剖学椎小关节距离（AVFD）、手术椎小关节距离（SVFD）和椎小关节角（VFA）。
C3-4、C4-5、C5-6和C6-7水平右侧的平均AVFD值显示出统计学上的显著差异。在右侧，平均SVFD值与AVFD值相当。所有水平右侧VFA的平均值显示出统计学上的显著差异。对于所有测量，C5-6和C6-7水平之间的差异最大，且较高水平与距侧隐窝的距离较小相关。右侧和左侧AVFD的平均值在所有水平均显示出统计学上的显著差异，且左侧的距离小于右侧。
颈椎较高节段的椎动脉比较低节段更靠近侧隐窝。在C5-6和C6-7水平发现的距离最大，且左侧椎动脉比右侧椎动脉更靠近侧隐窝。
