Shinomiya K, Okawa A, Nakao K, Mochida K, Haro H, Sato T, Heima S
Department of Orthopaedic Surgery, Tokyo Medical and Dental University School of Medicine.
Spine (Phila Pa 1976). 1994 Nov 15;19(22):2501-4. doi: 10.1097/00007632-199411001-00002.
This study analyzed anatomic characteristics of cervical ventral rootlets. After total vertebrectomy, detailed morphology of the ventral rootlets was studied from the anterior.
The clinical study showed the predominance of ventral root lesion. There are few studies concerning the morphologic pathogenesis of cervical amyotrophy and detailed cervical ventral rootlet anatomy.
Thirty-six embalmed adult human cadavers were studied. The measurements for the ventral rootlets of C5 to C8 were made as follows: 1) angle between the rootlet and spinal cord, 2) longitudinal width of the ventral rootlet origin, and 3) length of the ventral rootlets.
The C5 ventral rootlets were shorter and issued more obtusely from the cervical spinal cord than lower rootlets. The spinal cord segment of the deltoid muscle, indicated by the longitudinal widths of the C5 and C6 ventral rootlet exits from the spinal cord, were wider than the C7 and C8 segments. Preforaminal anterior compression at the C4-C5 disc level might affect the lower part of the C5 ventral rootlets and upper part of the C6 ventral rootlets.
Short C5 ventral rootlets appeared to become taut and easily injured by hemilateral anterior compression. Spinal cord lesion resulting from localized anterior compression at the single disc level might not play as important a role in the pathogenesis of dissociated motor loss of the deltoid muscle because of the wider spinal segments of C5 and C6.
本研究分析了颈前根丝的解剖学特征。在全椎体切除术后,从前方研究了前根丝的详细形态。
临床研究表明前根病变占主导。关于颈肌萎缩的形态学发病机制和颈前根丝详细解剖学的研究很少。
对36具经防腐处理的成年人体尸体进行研究。对C5至C8的前根丝进行如下测量:1)根丝与脊髓之间的角度;2)前根丝起始处的纵向宽度;3)前根丝的长度。
C5前根丝比下部根丝短,且从颈脊髓发出的角度更钝。由C5和C6前根丝从脊髓穿出的纵向宽度所指示的三角肌脊髓节段,比C7和C8节段宽。C4 - C5椎间盘水平的椎间孔前压迫可能会影响C5前根丝的下部和C6前根丝的上部。
短的C5前根丝似乎会变得绷紧,并容易因单侧前压迫而受损。由于C5和C6的脊髓节段较宽,单个椎间盘水平的局部前压迫导致的脊髓损伤在三角肌分离性运动丧失的发病机制中可能不发挥重要作用。