颈神经后支的解剖位置及其与侧块上关节突的关系。
The anatomic location of the dorsal ramus of the cervical nerve and its relation to the superior articular process of the lateral mass.
作者信息
Ebraheim N A, Haman S T, Xu R, Yeasting R A
机构信息
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo, USA.
出版信息
Spine (Phila Pa 1976). 1998 Sep 15;23(18):1968-71. doi: 10.1097/00007632-199809150-00009.
STUDY DESIGN
This study analyzed the anatomic relation of the dorsal ramus of the cervical spinal nerve to the lateral mass.
OBJECTIVES
To determine the location of the dorsal rami of the cervical spinal nerves from C3 to C7 in relation to the superior articular processes of the lateral masses.
SUMMARY OF BACKGROUND DATA
The anatomic study of the cervical spinal nerve and its relations to adjacent bony structures have been addressed. No previous anatomic study with regard to the location of its dorsal ramus relative to the lateral mass has been reported.
METHODS
Twelve specimens were obtained for study of the dorsal rami of the cervical spinal nerves. All soft tissues surrounding the cervical spinal nerves from C3 to C7 were dissected from the intervertebral foramens until the dorsal rami were clearly exposed. The facet joints in the corresponding levels were then opened by removal of the capsules. Three measurements, including the height of the dorsal ramus, the distance between the dorsal ramus and the tip of the superior articular facet, and the angle of the dorsal ramus relative to the superior articular surface, were taken for each ramus.
RESULTS
The results showed that the mean height of the dorsal ramus for both sides decreased progressively from C3 (2.2 +/- 0.6 mm) to C7 (1.2 +/- 0.2 mm). The mean distance between the dorsal ramus and the tip of the superior facet showed an inconsistent change, with the maximum value seen at C5 (7.4 +/- 1.6 mm) and the minimum at C7 (5.5 +/- 2.9 mm). The mean angle of the dorsal ramus relative to the superior articular facet ranged from 23.3 degrees +/- 14.3 degrees to 29.8 degrees +/- 11.2 degrees.
CONCLUSIONS
The dorsal ramus of the cervical spinal nerve is closer to the anterolateral corner of the base of the superior articular processes. Lateral mass screws directed to the anterolateral corner of the base of the superior articular process should be avoided.
研究设计
本研究分析了颈脊神经后支与侧块的解剖关系。
目的
确定C3至C7颈脊神经后支相对于侧块上关节突的位置。
背景数据总结
已有关于颈脊神经及其与相邻骨结构关系的解剖学研究。此前尚无关于其背支相对于侧块位置的解剖学研究报道。
方法
获取12个标本用于研究颈脊神经后支。从椎间孔解剖C3至C7颈脊神经周围的所有软组织，直至后支清晰暴露。然后通过去除关节囊打开相应节段的小关节。对每支后支进行三项测量，包括后支的高度、后支与上关节面尖端之间的距离以及后支相对于上关节面的角度。
结果
结果显示，两侧后支的平均高度从C3（2.2±0.6毫米）至C7（1.2±0.2毫米）逐渐降低。后支与上关节面尖端之间的平均距离变化不一致，最大值出现在C5（7.4±1.6毫米），最小值出现在C7（5.5±2.9毫米）。后支相对于上关节面的平均角度范围为23.3°±14.3°至29.8°±11.2°。
结论
颈脊神经后支更靠近上关节突基部的前外侧角。应避免将侧块螺钉置入上关节突基部的前外侧角。
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