摘要
目的研究胸段椎管及其毗邻骨性结构的形态、大小及相互关系,为胸段椎管的手术入路提供解剖学依据。方法取成人胸段脊柱干性骨骼标本15副,观察胸椎椎管及其周围骨性结构的形态及相互关系,测量相关骨性结构的大小和间距。结果胸椎椎管位于椎体的后方,胸椎椎管相对较小,以T1椎孔横径最大。胸椎的椎弓根内外径都小于1cm,最窄处不到4mm;其椎上切迹很不明显,椎下切迹非常突出,深度在8.5～10.5mm。胸椎的上关节突从后上方观察呈一"V"字形,T1的上关节突间距离最宽(约19mm),向下逐渐减小,至T5、T6节段最小(约8.5mm)。胸椎的横突向后侧方倾斜,其与正中矢状面所成的角度从第1胸椎至第10胸椎越来越小(从胸1的接近60°至胸10的36°),横突的长度从上至下也是逐渐减小,从横突末端至上关节突内侧缘的距离为25～30mm,至下关节突内侧缘的距离约30mm。结论胸椎椎管较小,后方入路暴露其腹侧困难;椎弓根、胸椎横突及与之相连的部分肋骨是侧方到达椎管前方的主要骨性障碍。
Objective To study the morphology and dimension and relation of the osseous thoracic vertebra canal （TVC） and its adjacent bony structures for further study of surgical approach in this area. Methods Bony TVC and its adjacent bony structures were observed and measured on 15 dry thoracic spine（TS）. Results The TVC was located posterior to the vertebral body and anterior to the lamina and articular process. The TVC was relative narrow. Among them the vertebra foramen of T1 was the broadest one. The thickness of the pedicle was less than lcm（the most narrow level was less than 4mm）. The superior vertebral incisure was not obvious but inferior vertebral incisure was deep（ the depth was 8.5 - 10.5mm）. The superior articular process（SAP） was v - shaped from superior - posterior view. The distance between left and right SAP of T1 was the broadest（ about 19mm） and T5,6 was the most narrow level. The transverse process extended posteriorly and formed an angle with the median sagittal plane, which decreased from T1 to T10（about 60°at T1 level and about 36°at T10 level）. The length of the transverse process decreased from T1 to T12,too. The distance from the end of the transverse process to the median rim of the SAP was 25 -30mm and the distance from the end of the transverse process to the median rim of the inferior articular process was about 30mm. Conclusion The TVC was relative small. It was difficult to expose its ventral part via posterior approach. The pedicle , transverse process and little segment of the adjacent rib were the primary bony obstacle to the ventral TVC.
出处
《安徽医学》
2008年第4期401-404,共4页
Anhui Medical Journal
关键词
胸椎椎管
横突
关节突
椎弓根
Thoracic vertebra canal
Transverse process
Articular process
Pedicle
