Orrison W W, Eldevik O P, Sackett J F
Radiology. 1983 Feb;146(2):401-8. doi: 10.1148/radiology.146.2.6687370.
Three significantly different lateral approaches to the cervical subarachnoid space (anterior, midplane, and posterior needle positions) have been previously described for cordotomy and myelography. Experimental lateral C1-2 punctures were performed by each of these three methods in anatomic specimens, cadaver models with reconstituted cerebrospinal fluid pressures, a patient with cerebral death, and to a limited degree in patients undergoing routine cervical myelography. In the cervical region the dura is pushed ahead of the needle, forming a "tent" over the needle tip during C1-2 puncture; the needle projects several millimeters into the spinal canal before penetrating the dura, regardless of the method of entry or needle diameter. The extent of this tenting phenomenon and its relationship to the spinal cord are significantly affected by the needle diameter and position. A posterior technique for lateral C1-2 puncture is described.
先前已描述过三种用于脊髓切断术和脊髓造影的显著不同的进入颈蛛网膜下腔的外侧入路（前位、中位面和后位穿刺位置）。通过这三种方法中的每一种，在解剖标本、具有重建脑脊液压力的尸体模型、脑死亡患者以及在有限程度上对接受常规颈椎脊髓造影的患者进行了C1-2外侧穿刺实验。在颈部区域，硬脑膜在穿刺针之前被推开，在C1-2穿刺过程中在针尖上方形成一个“帐篷”；无论进入方法或针的直径如何，针在穿透硬脑膜之前都会伸进椎管几毫米。这种帐篷现象的程度及其与脊髓的关系受到针的直径和位置的显著影响。本文描述了一种C1-2外侧穿刺的后位技术。
