【摘要】： [目的]觀測椎管內(nèi)臂叢神經(jīng)前后根的形態(tài)及特點，并闡明臂叢神經(jīng)前后根與椎間孔的空間毗鄰關(guān)系及其意義，為臂叢根性撕脫傷及神經(jīng)根型頸椎病的診治和前者修復(fù)手術(shù)的改進提供解剖學(xué)基礎(chǔ)。 [方法]取正常人體脊柱防腐標(biāo)本15個。打開頸椎管，顯露雙側(cè)臂叢神經(jīng)，測量椎間孔內(nèi)外口平面臂叢神經(jīng)的斷面面積、椎間孔外口平面面積和椎間孔上下徑、前后徑；測量椎管內(nèi)C_5-T_1神經(jīng)前后根各級分支數(shù)目及其長度；并且測量C_5-T_1神經(jīng)前根與脊髓縱軸的夾角；前后根起始處距脊髓前后正中溝的距離。 [結(jié)果]椎間孔內(nèi)、外口處臂叢神經(jīng)斷面面積測量顯示：C_5到C_8逐漸增加，T_1神經(jīng)根最細(xì)。而椎間孔內(nèi)(外)口處臂叢神經(jīng)斷面面積分別由C_5的14.0±1.37mm、21.0±1.83mm逐漸增加到C_8的24.2±2.68mm、30.3±3.93mm，各椎間孔外口處臂叢神經(jīng)斷面面積比上椎間孔外口面積均約為1／3；臂叢神經(jīng)前根根絲數(shù)目C_5最多，達(dá)10.1±3.3，后根根絲數(shù)目C_6最多，達(dá)9.7±3.5，二者向下均逐漸減少；前后根的長度分別從C_5的15.62±1.88mm、12.73±1.77mm逐漸增加到T_1的22.33±2.16mm、22.00±2.08mm，且相應(yīng)的前根比后根要長；前后根A段和B段的長度，均從C_5到T_1逐漸增加；前根與脊髓縱軸的夾角從C_5的60.25°逐漸變小到T_1的30.03°。 [結(jié)論]1．椎間孔處韌帶對神經(jīng)根有固定作用，，在神經(jīng)根斷裂的發(fā)生中起著至關(guān)重要的作用，并且該結(jié)構(gòu)決定著臂叢神經(jīng)損傷的分型。2．本實驗結(jié)果提示：神經(jīng)根型頸椎病是否發(fā)生，其癥狀的嚴(yán)重程度，并不取決于椎間孔截面面積的絕對值大小，而是由椎間孔截面面積與椎間孔處臂叢神經(jīng)斷面面積比決定的。3．本實驗對椎間孔內(nèi)口處臂叢神經(jīng)斷面面積的測量，為發(fā)生于椎間孔內(nèi)口處的神經(jīng)根型頸椎病在影像診斷中神經(jīng)根受壓程度的定量判斷提供解剖學(xué)參數(shù)。
[Abstract]:[objective] to observe the morphology and characteristics of the anterior and posterior roots of the brachial plexus nerve in the spinal canal, and to elucidate the spatial relationship between the anterior and posterior roots of the brachial plexus nerve and the intervertebral foramen and its significance. To provide anatomical basis for diagnosis and treatment of brachial plexus root avulsion and nerve root type cervical spondylosis. [methods] Fifteen specimens of normal human spine were collected. Open cervical canal, expose bilateral brachial plexus nerve, measure the area of brachial plexus nerve in internal and external orifice of intervertebral foramen, the area of external orifice of intervertebral foramen and the upper and lower diameter of intervertebral foramen, anteroposterior diameter; The number and length of the branches of the anterior and posterior roots of the C_5-T_1 nerve in the spinal canal, the angle between the anterior root of the C_5-T_1 nerve and the longitudinal axis of the spinal cord, and the distance from the beginning of the anterior and posterior roots to the median sulcus of the spinal cord were measured. [results] the measurement of the area of brachial plexus nerve section in intervertebral foramen and external orifice showed that C _ 5 to C _ S _ 8 increased gradually, and T _ 1 nerve root was the thinnest. The area of brachial plexus in intervertebral foramen increased from 14.0 鹵1.37 mm to 24.2 鹵2.68 mm and 30.3 鹵3.93 mm, respectively, from 14.0 鹵1.37 mm to 24.2 鹵2.68 mm 鹵3.93 mm, respectively. The area of brachial plexus at the external orifice of intervertebral foramen was about 1 / 3 of that at the external orifice of superior intervertebral foramen. The number of anterior root filaments of brachial plexus was the highest (10.1 鹵3.3), and the number of posterior root filaments of C _ (6) was the highest (9.7 鹵3.5). The length of anterior and posterior roots increased from 15.62 鹵1.88 mm / 1.77mm to 22.33 鹵2.16 mm and 22.00 鹵2.08 mm respectively, and the length of anterior root was longer than that of posterior root. The length of A and B segments of the anterior and posterior roots increased from C _ 5 to T _ S _ 1, and the angle between the anterior root and the longitudinal axis of the spinal cord gradually decreased from 60.25 擄of C _ 5 to 30.03 擄of T _ 1. [conclusion] 1. Ligaments at intervertebral foramen play an important role in nerve root fixation and play an important role in the occurrence of nerve root rupture. 2. And this structure determines the type of brachial plexus nerve injury. 2. The results suggest that the severity of the symptoms does not depend on the absolute value of the cross-sectional area of intervertebral foramen. It was determined by the ratio of the cross-sectional area of intervertebral foramen to the area of brachial plexus at intervertebral foramen. 3. To provide anatomical parameters for quantitative determination of the degree of nerve root compression in imaging diagnosis of cervical spondylopathy with nerve root occurring at the interforaminal orifice.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2007
【分類號】：R322

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