健侧C7 神经移位经椎体前通路的解剖学研究及经颈椎后入路 解剖学探讨

目的:为临床上开展健侧C7神经移位经椎体前通路治疗臂丛损伤提供解剖学基础。方法:选取10具20侧正常成人尸体颈段标本,将双侧臂丛充分显露,远端向C7神经根前后股进行干支分离,在前后股加入外侧束及后束前将其切断,近端向椎间孔处游离,测量C7神经根从椎间孔至分股处的长度及C7神经至前后股长度,测量并记录C7神经根及前后股经椎体前通路、颈前皮下通路到对侧臂丛上、下干的距离。结果:C7神经根的长度(58.62±8.70)mm,C7神经前、后股的长度(70.03±10.79)mm,(65.15±9.11)mm,C7神经根经颈前皮下、椎体前通路至对侧上下干的缺损长度分别是(98.18±10.18)mm,(107.14±9.88)mm;(32.10±11.49)mm,(37.28±10.01)mm两组相比有统计学差异。结论:从解剖学角度而言,健侧C7神经移位经椎体前通路能明显缩短移植神经长度,在临床上具有可操作性。

The Anatomical Study of Contralateral C7 Transfer Through the Prespinal and the Posterior Cervical Route

Objective: To provide anatomical basis for the contralateral C7 nerve transfer through the prespinal route for brachial plexus avulsion injuries in the clinical.Methods: The bilateral brachial plexus were exposed on 20 sides of 10 cadaveric specimens of adult.The C7 nerve root was sectioned at the junction site of trunk and division,and then dissected proximally to the foramina.The fol-lowing data were recorded: the length of bilateral C7 nerve,the length of the anterior and posterior division of C7,the distance be-tween the roof of C7 and the upper trunk and the lower trunk at the affected side through prespinal route and a subcutaneous tunnel on the anterior surface of the neck.Results: The length of anterior and posterior division of C7 was(70.03±10.79)mm and(65.15±9.11)mm,The distance between the roof of C7 and the upper trunk at the affected side through prespinal route and a subcutaneous tunnel on the anterior surface of the neck was(32.10±11.49)mm and(93.18±10.18)mm,The distance between the roof of C7 and the lower trunk at the affected side through prespinal route and a subcutaneous tunnel on the anterior surface of the neck was(37.28±10.01)mm and(113.14±9.88)mm,there were statistical significance among them(P<0.01).Conclusion: From the point of anatomy,the contralateral C7 transfer through the prespinal can shorten obviously the length of nerve anastomosis.There is possibility of the clinical appli-cation of contralaeral C7 nerve transfer for brachial plexus by prespinal route.