CAJ | 학술논문

目的了解椎动脉与寰枢椎之间的解剖学关系,为临床手术提供指导.方法 10例(20侧)防腐固定成人尸体标本,均行彩色硅胶血管灌注,测量椎动脉到C2脊神经节、中线及其他手术相关标记的距离,观察椎动脉与椎体之间的关系.结果椎动脉V2段至C2脊神经节外侧端平均距离为7.7 mm,至硬膜的平均距离为15.6 mm.双侧椎动脉粗细可见明显差异.V1～3段椎动脉并未完全占据横突孔,可在横突孔内相对活动.结论椎动脉在寰枢椎区域连续弯曲走行,使得在此区域的手术极易损伤椎动脉,详细了解此区域解剖学特点有助于减少椎动脉损伤.
목적 료해추동맥여환추추지간적해부학관계,위림상수술제공지도.방법 10례(20측)방부고정성인시체표본,균행채색규효혈관관주,측량추동맥도C2척신경절、중선급기타수술상관표기적거리,관찰추동맥여추체지간적관계.결과 추동맥V2단지C2척신경절외측단평균거리위7.7 mm,지경막적평균거리위15.6 mm.쌍측추동맥조세가견명현차이.V1～3단추동맥병미완전점거횡돌공,가재횡돌공내상대활동.결론 추동맥재환추추구역련속만곡주행,사득재차구역적수술겁역손상추동맥,상세료해차구역해부학특점유조우감소추동맥손상.
Objective To study the anatomical relationship between C1-2 and Vertebral artery.Methods Ten adult cadaveric specimens were studied.The veins and arteries were injected with silicon pigments.We followed the nomenclature clarified by Cacciola.The artery during its course from the transverse process of C3 to the transverse process of axis was named after V1 segment,the artery during its course from the axis transverse process to the atlas transverse process was named after V2 segment and the segment of the artery after its exit from the transverse foramen of atlas to the point of its dural entry was named after V3 segment.The relationship of the artery to the atlanto-axial joint and facets,distance of the location of the artery from the midline,from the C2 ganglion and from the other surgical landmarks were researched.The extent of occupancy of the artery into the vertebral artery groove on the inferior surface of the superior facet of the axis,and over the posterior arch of the atlas were studied.Results The V1 segment of the vertebral artery took a varying degree of loop inside the vertebral artery foramen on the inferior aspect of the superior facet of the axis.The loop extended towards the midline and was at an average distance of 14.6 mm from the midline of the vertebral body.The V2 segment of the artery took an initial lateral loop after its exit from the transverse process of the axis.The average distance of the artery from the lateral end of the C2 ganglion was 7.7 mm and from the dural tube was 15.6 mm.The vertebral artery groove in the superior facet of axis and the groove over the posterior arch of the atlas were completely occupied by the vertebral artery only in six sides and in none respectively,suggesting the possibility of the dynamic nature of the relationship of the artery to the bone.Conclusions The vertebral artery adopts a serpentine course in relationship to the axis,making it susceptible to be injured during the surgical procedures in this region.The foundation of reducing the possibility of vertebral artery injury is to be familiar with its anatomy characteristic.